[The large nose--an esthetic, but also a functional problem]

The term "Big Nose" describes many deformities caused by hypertrophy of the bone or the cartilagenous framework of the nose or both. This leads to disharmony of the face, which discomforts the patients. By diminution of the naso-labial angle as for example in a "Pinocchio nose" or by the reduced angle of the inner valve like in a tension nose, a "Big Nose" presents not only an aesthetic problem but a functional one too. An exact analysis of the deformity is necessary to choose the adequate operative procedure. The reduction of the nose should lead to an improvement in "looks" as well as in breathing. The most challenging factor in nose reduction is the diminution of the tip projection. Two different methods are mainly available: the technique according to Goldman and to Lipsett. The pros and cons of both are compared and a few refinements suggested.