Can I Elevate my Tip to Disguise my Hump Without Dorsal Rasping?

I think the better way to improve your profile is to build up the bridge of your nose in the area called the radix.  This is the portion of your bridge above your hump.  This will give you a more feminine profile, while making your nose and face appear slightly more narrow.  Removing the hump will make your nose appear wider.  Rotating the tip will not have a significant effect on the appearance of the hump. 

The tip cannot be raised high enough to make the hump go away.  The hump will need to be surgically removed.  A small hump can be simply rasped but a large hump will require osteotomies.  In addition, the depressor septi ligament of the tip will need to be softened to prevent the tip from drooping upon smiling.  To raise the tip, suturing techniques of the nasal tip cartilages will need to be performed.

Hi Shanghai;

I understand your thought process, and it is a good one.  Your photographs are also very helpful.  I am sure that when you raise the tip of your nose, the migration upward makes the bump look like it is going to be gone. 

In the operating room, that will not happen.  You need to have the bump removed.  When the tip is rotated up, you will certainly have a better profile.  I do appreciate the fact that when you smile, the tip plunges, which is because you have a very active depressor septi muscle, which your cosmetic surgeon will certainly manage properly. 

The most important thing: when you have rhinoplasty, all the elements must be considered and dealt with.  The ports of the nose are connected to each other, and a change in one can affect the appearance, and even function, of the adjacent area.  That is why the rhinoplasty surgeon engages in a lot of thought when performing the procedure.  He has to understand what changes occur, not only in the tissues he is operating on, but on those adjacent tissues, and how they will heal. 

In your case, the bump should definitely be removed; although, it can be done very conservatively, certainly.  I do not know that you necessarily need to have an implant.  The tip will come up, but if your preference is to have a stronger tip, you may want to have an implant, or the use of some filling injections at some point.

At consultation, you should have a very frank discussion with your surgeon as to what you want to have and how likely it is that your desires can be achieved.  It is important to have computer imaging, so that you can both look at the proposed changes and have a "meeting of the minds."

I am anticipating that you will have an excellent result because you have excellent facial features and this augers well for your satisfaction.

Robert Kotler, MD, FACS
Facial Plastic Surgeon
Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
Author, THE ESSENTIAL COSMETIC SURGERY COMPANION