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Filing Down the Dorsal Hump Without Osteotomy?

asked 2 years ago by anon
Latest answer by Rian Maercks, MD
Question viewed 2,668 times
Tags: nose, dorsal hump, broken nose, shape, tip

I have a prominent dorsal hump. From frontal view you don't notice anything but on side profile there is clearly a big bump. My dorsal hump feels really irregular and uneven in bone structure (I also broke my nose 4yrs ago).

I was wondering if I could slightly reduce the bump (while keeping my tip of my nose the same) and have no need for an osteotomy (just filling off some of the bump even though it is big)

20 answers to Filing Down the Dorsal Hump Without Osteotomy?

Dorsal Hump Removal without Osteotomies

You ask if you can "slightly reduce" the hump without osteotomies. More than a subtle reduction will make the nose flat and wider. Rely on the advice of your surgeon to determine what can be achieved. At least consider the osteotmies -- the result of this surgery wiil last the rest of your life.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Reducing dorsal hump

The nose is a pyramidal structure. Reducing a hump makes the nose wider. That is the main reason for performing an osteotomy, or narrowing the top of the nose. Filing alone can result in a "boxer's nose", one that is flat and wide. Your plastic surgeon can guide you through what decision to make, and on how to maintain the breathing or improve it even if the dorsum of the nose is being narrowed.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

Addressing a dorsal hump in rhinoplasty: Is an osteotomy required?

Removing a dorsal hump ABSOLUTELY requires osteotomy to avoid a unaesthetic and progressive deformity called 'open roof deformity.' Essentially filing down the bony pyramid of the nose removes the roof of the pyramid which would lead to a strange contour and appearance if left alone. An osteotomy allows the roof to close back to a pyramidal shape and allows an aesthetic result. Be very wary of a surgeon who promises you a dorsal reduction without an osteotomy... more

Rian Maercks, MD
Miami Plastic Surgeon

Filing Down the Dorsal Hump Without Osteotomy in nose surgery?

Small dorsal humps (sounds like yours is NOT) can be rasped a few millimeters; if more hump is taken off, you'll be left with an open roof and will need osteotomies. These are just precise cuts in the bone, but the thought of "breaking the nose" frightens patients, and they frequently ask "Are you going to break my bones?". You should consult with experienced facial plastic surgeons and trust the one you choose to do whatever necessary to achieve optimal... more

Ramtin Kassir, MD
New York Facial Plastic Surgeon

Rhinoplasty without osteotomies

Yes, you certainly can have rhinoplasty without osteotomies. It's done rather frequently in fact. Bone cuts (lateral osteotomies) are made at the sides of your nasal bridge. They narrow the middle part of the bridge of the nose. They have little effect to the root of your nose between the eyes nor the base of your nose above the lip. They have no effect on your nasal hump. As your bridge is lowered, the width of your bridge becomes greater. At some point it becomes too wide and lateral... more

Oakley Smith, MD
Toronto Facial Plastic Surgeon

www.droakleysmithrhinoplasty.com

Reducing hump without narrowing the nose

Without examining you, I cannot give a definitive answer. The nose (from the base) looks like a pyramid. Imagine filing the top of the pyramid down. If the base of the pyramid was wide to begin with, then the nose appears even wider from the frontal view. This is an optical illusion. If this is the case, then there is no harmony between the top of the nose and the bottom. An osteotomy is then required to narrow the upper portion of the nose.

Michael A. Jazayeri, MD
Santa Ana Plastic Surgeon

Big nose bridge reduction needs osteotomies, small one doesn't

The more the bridge is lowered, the flatter the nose looks and the more likely an opening (open roof) will occur on the bony bridge. Osteotomies can remedy both of these undesirable side-effects. If the bridge is lowered just a bit, osteotomies may not be necessary. An alternative to creating a nice profile in the presence of a small hump is to augment the bridge above the hump and elevate and project the nasal tip forward a bit. If osteotomies need to be performed, a skilled surgeon... more

David W. Kim, MD
Bay Area Facial Plastic Surgeon

Dorsal hump reduction without osteotomy is all about harmony

To simply answer your question, yes you can only have the hump reduced but you must understand that there should be harmony between the bridge of the nose and the tip. The nose is the most central portion a persons' face and if the nose is not harmonious among its parts it can disrupt the overall facial aesthetics. Rhinoplasty is not simplistic. 1. When the hump is reduced this creates a wide nasal bridge. Osteotomies help narrow the nose. 2. Once the bridge is narrowed this may create a... more

Earl Stephenson Jr., MD, DDS
Atlanta Plastic Surgeon

Filing down dorsal hump without osteotomy

Without good photos the simple answer is YES! But again most likely you will need fracturing or osteotomies. See 3 boarded plastic surgeon in your area. Regards.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Subtle Rhinoplasty: Filing down the dorsal hump without osteotomy?

Hi, It depends on your anatomy, but in many cases, the dorsal hump can be filed down without the need for osteotomies. A subtle rhinoplasty tailored to your individual needs can be obtained, just make sure that you choose your rhinoplasty surgeon most carefully. See the below web reference for more on the "subtle rhinoplasty". Good luck and be well. Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Filing down a small nasal hump

Small residual nasal humps can gently be filed down especially if they are the result of trauma with a rasp. This can often be done without doing osteotomies to narrow and infracture or break the nose. However, if the hump is very large and you file it down to provide a smooth profile, then you will need to do osteotomies to narrow the nose and close the flat spot called an "open roof". This is analogous to building a house. If you take down the roof it is open unless you push the... more

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon

Correction of the nasal hump without breaking the nasal bones.

This can be done by filing it down only when the hump is small. Otherwise the nasal bones will be apart and flat. This is why we have to do osteotomies when we remove the average sized hump.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

Sometimes you don't need osteotomy in rhinoplasty.

Hi. Of course, the surgical plan is made only after detailed examination. So I don't know exactly what you need. But we do see patients in whom the bump can be lowered with a rhinoplasty without osteotomies.

George J. Beraka, MD
Manhattan Plastic Surgeon

Dorsal nasal rasping without the need for osteotomies

Yes, you can perform a slight bridge correction with rasping alone, but it is for very select patients. One, is that patient that has a very subtle dorsal hump, and I would agree that 1 mm is about all that can be safely removed. Any more than this, and the rasp will uncover the intranasal cavity, which shows up externally as a slight single or double depression on each side of the septum that runs vertically in the upper third of the nose. As mentioned, the second part of an open roof... more

Kevin Robertson, MD
Madison Facial Plastic Surgeon

Dorsal hump removal without osteotomy depends

Hi Ella, This all depends on the extent of the dorsal hump. I have taken some down that do not need an osteotomy and others that did. If its a small dorsal hump then its possible, if its on the larger side, you may need an osteotomy in order to prevent an "open roof deformity". An open roof deformity is, if you can imagine what would happen to the roof of a house if you shaved the top off, you'd have an open roof. Hope this helps, Best, Dr.S

Oleh Slupchynskyj, MD
New York Facial Plastic Surgeon

www.facechange.org

Dorsal reductions with / without infractures

If you have small dorsal hump, a slight (1-2mm) reduction can generally be performed without needing in-fractures. If you have a significant dorsal hump, in-fractures are needed for 2 reasons: Open Roof Deformity - quite well explained by Dr. Aldea (Too) wide dorsum - Think of your nasal bones as the Pyramids in Egypt. If you decided to remove the top 1/2 of the pyramid and then viewed it from above, the tip would no longer be a sharp point, but rather a wide and flat level region. If... more

Michael A. Bogdan, MD
Dallas Plastic Surgeon

Flat nasal bridge after smoothing hump

Depending on the extent of filing, you could end up with a flattened surface along the top of your nose. If you only have a little flattening done you might be able to get away without osteotomies, but you would likely not have the degree or improvement you would like either. With more flattening you really do need to move the bones inward to recreate a nice rounded dorsum. It is typical to need to do this with most rhinoplasty and the only times I have seen someone who didn't have it done... more

Robert B. Pollack, MD
La Jolla Plastic Surgeon

Don't set restrictions on your Rhinoplasty surgeon

A rhinoplasty is a complex operation even for me with 35 years of experience doing them. Don't restrict your surgeon--if an osteotomy is needed let it be done. You won't feel it or even know it was done. If you have a good tip, maybe nothing will need to be done. Speak to an expert--we have a lot of experience and can guide you in how to deal with your problem.

William B. Rosenblatt, MD
New York Plastic Surgeon

The open roof deformity

As Dr. Aldea has so nicely expalined, when removing a large dorsal hump (not overdoing it either) there will be a flattness of the dorsum called an "open roof deformity." It is to correct this that infracturing is done. It doesn't add anything to the recovery other than a little more bruising under the eyes so it is nothing to be afraid of. Patients should tell their surgeons what bothers them and then let the surgeon do what they need to do to correct it. In most large dorsal... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Can a Large Nasal Dorsal hump be "filed down" WITHOUT having to break the Nose?

The appearance of the nose depends on the ability of the covering skin to drape properly on top of it. When a large nose hump is filed down, it literally looks like a rowing boat, flipped over whose bottom had been sawed off and covered with a light cloth - in other words - flat bottomed. The ONLY way to restore the narrow look of the nasal dorsum is to break the sides of the cheek bones meeting the nose and push them together - this is called osteotomies. While a small hump MAY be able to... more