I'm unhappy with the profile of my nose. (I don't have a problem with it face on.) I'm asking whether i appear to be suitable for such a procedure, what the risks are, and whether filing/rasping the nose is usually cheaper than a rhinoplasty that involves breaking bones. I have read that 'shaving down a bony hump may cause a flattened appearance which will then need to be infractured to close the the "open" roof.' Would this all be done in one session?
Would Filing Down the Dorsal Hump Be Suitable to Improve the Profile of my Nose?
Doctor Answers (14)
Good photography. You would be a good candidate for rasping down the nasal hump. In your case, based on the size of your hump and narrowness of your nasal vault, I don't think you need osteotomies.
I would first thank you for the excellent photos. And yes I would file down the hump very slightly than do a fracture. That is my opinion. From MIAMI DR B
Removing dorsal hump to improve profile
Performing a rhinoplasty usually includes taking the bone and cartilaginous hump down. Once this is done, osteotomies are performed to complete the dorsal reduction and prevent open roof deformity. Most rhinoplasty procedures are all done in one session. There is approximately 10% chance of having to perform a touchup or revision rhinoplasty within the first year after the surgery in case a small hump grows back.
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Improving Nasal Profile
The hump can be removed so you have a strong, straight profile. It will be necessary to reposition the nasal bones during the same surgery to avoid a wide, flat "open roof" appearace.
Simple rasping down of dorsum
We are at a point in plastic surgery where many people who have minor issues with their appearance can be helped. A rasping of the dorsum can be performed without other procedures under mild sedation. If the rasping is extensive then other additional procedures may be required.
Tal Raine MD
Dorsal Hump Improvement Rhinoplasty
Yes, nasal humps may be improved with rasping, filing, or burring down the nasal bones. Dorsal humps are made of bone, cartilage, or both. Once the bump is treated, then the nasal bones may need to be brought closer together to "close the open roof". Your plastic surgeon will help determine if bone in-fracture is required prior to rhinoplasty surgery. This nasal bone narrowing would be done at the same time as hump reduction, and normally is included in the cost of rhinoplasty.
Rhinoplasty is not one operation, but rather many potential procedures to improve the appearance and function of the nose. The cost of rhinoplasty varies greatly, but it's usually similar for plastic surgeons in your area. Portions of rhinoplasty surgery may also be covered by your insurance provider. After a comprehensive evaluation can your plastic surgeon help determine appropriate options for you.
Filing a Hump off the back of the Nose would require in breaking of the Nose
Reducing the dorsal hump and infracture in rhinoplasty
Reduction of the dorsal hump is possible through rasping the bones, and this may result in an open roof where the nasal bones are separated from the septum. Achieving a smooth dorsum would then require infracture to reposition the nasal bones. All of these maneuvers would be possible in one operative session.
Filing down the dorsal hump is reasonable but you will probably need infracturing. Also in the front view you have some curvature( or shadowing from the photo) that you may want corrected.
Consider a filler for the root of the nose
Another option to consider that requires little expense and virtually no downtime is to fill in the radix of the nose (the indentation above the hump and below the brow ridge). This provides a straight profile by camouflaging the bump at the expense of a slightly larger but more proportionate nose. This is an in-office, local-anesthesia-only procedure with essentially immediate results.
I would start with a temporary filler such as Juvéderm first to see whether the patient likes the appearance (pre-procedure computer imaging helps a lot here, too, before we do any filling). If the patient likes the result, it can later be made permanent with Artefill, at least here in the U.S.
All the best,
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.