Many of my plastic surgery consulting patients make note of their “hook nose” shape that they particularly dislike. What causes a hooked shaped nose and how is it treated with a hook nose rhinoplasty? Why does a hook nose shape appear worse when smiling? Can a hook nose shape be corrected with a rhinoplasty?
A hooked nose is not an abnormality of the nose. It’s a different shaped nose that actually is more frequent in people of certain ethnicities – it’s an inherited feature that can run in families. The actual shape of a hooked nose typically results from an overgrown septum that pushes the tip of the nose down. The nose is typically long in appearance with a short columella and a high dorsum or nose bridge. Although most ordinary noses become wider and droop more when smiling, this feature is exaggerated in those with a hook nose because of the anatomy.
Treatment of a hook nose shape is very much dependent on the anatomy of the patient. The overgrown septum is shaped more like a normal septum and often the tip complex cartilage itself is manipulated and shaped, so it resembles a normal nose. This may or may not include suture techniques for a hook nose shape and even cartilage grafting as needed (typically a columella strut graft to lengthen and support the new tip shaped up at surgery).
As always, the hook nose rhinoplasty surgeon must focus on the entire nose and not just the tip shape. Proper nose balance is all about the nose having a certain shape that is typical – a dorsum that is lower than the tip complex and a nose that isn’t long and droopy at the tip. My job is to work the entire nose so it looks beautiful and proportional to your face.
After treatment for a hook nose your nose should still look like a normal nose. You can smile as big as you like and it won’t droop like it did before. The greatest personal insecurity that sits in the middle of your face will be no longer. Your new nose fits your face better. It looks unoperated and natural. It compliments your face. It’s your nose just a lot better. In fact, I’m not sure that anyone will even notice your new nose other than comments like “you look different and I can’t tell why!” This is a hook nose job home run.