78%

874 reviews

Worth It Rating Our index shows the percentage of community members saying this was "Worth it". See cosmetic treatment rankings

Rhinoplasty Cost ≈ $6,300 average cost

Write a review | Ask a Question

Filing Down the Dorsal Hump?

I have a small dorsal hump that I would like to get fixed on my nose, and was considering closed rhinoplasty. The plastic surgeon informed me that he could just go in and file it down without breaking or fracturing any bones. Does this sound like a good idea? The absolute only thing I want done is the hump shaved down, and it is very small. Will any other part of my nose need fixing if the surgeon simply files the hump down?

Asked 38 months ago by Star05 in Neport Beach, CA, USA

Tags:

Yes-if it is small.

If the bump is small, as you say, the answer is yes, and you don't have to do anything else to the nose. If that is all that bothers you, you don't have to do the "whole nose"!

Doctor's Website

Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon

Filing down a nasal hump in closed rhinoplasty

If the only issue with your nose is the hump, you can absolutely have this addressed with a closed, or endonasal rhinoplasty. In most cases, the hump is comprised of both bone and cartilage and some combination of shaving, filing, and chiseling the hump is utilized. The important preoperative assessments for the surgeon are the size of the hump, the degree to which the patient wants to lower the bridge, and the length of the nasal bones. If the patient does not desire a... more

Doctor's Website

Umang Mehta, MD

Bay Area Facial Plastic Surgeon

Small nasal hump can be removed with a Closed Rhinoplasty

If the nasal hump is small and consists only of extra nasal bone a simply filing with a closed rhinoplasty approach is sufficient. If the hump is larger or involves the upper lateral cartilages of the middle of the nose than simple removal may cause a flat spot called an open roof deformity. When this is the case the nasal bones nee to be brought closed together by infracturing the nasal bones to recreate the natural pyramid of the nose.

Andrew Jacono, MD

New York Facial Plastic Surgeon

Hump Removal via a Closed Rhinoplasty

Patients with a dorsal hump are ideal candidates for closed rhinoplasty. A dorsal hump is usually comprised of both bone and cartilage. To remove a hump, an incision is made on the inside of the nose and a rasp is used to "file" the bony portion of the hump. If there is a cartilaginous component to the hump, this is trimmed with a scalpel. One result of a hump removal is that it makes the bridge wider and may require osteotomies (breaking the nasal bones) to narrow the width of... more

Doctor's Website

C. Spencer Cochran, MD

Dallas Facial Plastic Surgeon

Closed Rhinoplasty

If your only issue is a dorsal hump, a closed rhinoplasty can be a great way to treat the contour of the dorsum with rasping. Rhinoplasty surgery is very complicated and the balance, shape and integration of the structure of your nose with the rest of the face is a critical consideration when planning what you do and don't need. In my San Francisco area practice we spend significant time analyzing the face. Make sure that your plastic surgeon spends considerable time discussing things... more

Steven H. Williams, MD

San Francisco Plastic Surgeon

ASPS

Yes, a small bony hump can be filed down easily

In my experience, there are other subtle areas of the nose that don’t get your attention now but may later. A thorough analysis of your nose and discussion is very necessary. You may also need slight modification of the nose below the hump and even slight change of the tip. Have a long discussion of these issues now rather than after surgery.

Harold J. Kaplan, MD

Los Angeles Facial Plastic Surgeon

A dorsal hump can be composed of bone and cartilage, and the hump can be satisfactoril

Smoothed out through a closed, reduction rhinoplasty. In this procedure, an incision is made on the inside of the nose and the surgeon gains exposure to the hump without going through the outer skin. The hump is then removed, and "rasped" or sanded down to a smooth contour. In some patients, the operation is essentially over at this point, but others can be left with a widened or open roof of the nose under the area where the hump had formerly been. In this... more

Doctor's Website

Michael H. Rosenberg, MD

White Plains Plastic Surgeon

ASAPS ASPS

Small nose hump: less is more!

A small bump on the nose can be smoothed and straightened by filing or shaving it down through small hidden incisions. By itself, this is a quick and straight forward procedure to perform (in experienced hands!) and requires just a few days to a week of recovery time and is not uncomfortable for you. For medium and larger sized bumps, the bones of the nose may need to be broken and then narrowed, and some cartilage may need to be surgically placed to... more

Ariel N. Rad, MD, PhD

Baltimore Plastic Surgeon

ASPS

Correction of hump on nose

Dear Star: It sounds like you are very clear about your surgical goals and how you would like your nose to look. As the other physicians have mentioned, there are some important considerations for your nose: the structure of the hump itself (bone vs cartilage) and maintenance of the overall balance and harmony of your nose. I would advise you to be sure and discuss these with your surgeon before you make your decisions. A small hump can generally be approached via the endonasal (closed)... more

Travis L. Shaw, MD

Richmond Facial Plastic Surgeon

Reducing a small or large dorsal hump is one of the most common reasons for seeking rhinoplasty surgery

Reducing a small or large dorsal hump is one of the most common reasons for seeking rhinoplasty surgery. With a very small dorsal hump, sometimes all that is required is filing down the vertical height of the nasal bones. With a larger hump, often once the nasal bones are filed down, this will create an “open roof” deformity where the dorsal of the nose looks flat. In this case, cuts in the lateral/outside aspect of the bones is required so that they can be collapsed down to... more

Michael R. Macdonald, MD

Bay Area Facial Plastic Surgeon

Filing down dorsal bump

Assuming the bump is quite small, and involves bone and not cartilage, it can be simply filed down. Oftentimes, the bump may also involve cartilage, which still can be taken down by a closed rhinoplasty surgery, and not require any breaking of the bones.

Doctor's Website

Jeffrey S. Epstein, MD

Miami Facial Plastic Surgeon

Filing down small dorsal hump of nose in rhinoplasty

The "dorsal hump" is mostly cartilage, and is less amenable to rasping or filing down than sharp resection. The osseous (bony) portion will likely need incremental reduction by filing. You and your surgeon need to be ready for more surgery however, depending on the result after filing and resecting the dorsum and rounding it off. If there is an "open roof," spreader grafts and/or osteotomies may be necessary. In rhinoplasty, when you change one... more

Doctor's Website

Steve Laverson, MD

San Diego Plastic Surgeon

ASAPS ASPS

Dorsal Hump Correction

Based on your description of this minor dorsal hump, it certainly seems amenable to closed rhinoplasty with filing/rasping. Larger dorsal humps tend to involve both bone and cartilage and additional steps to be certain that an "open sky deformity" is corrected by cutting the nasal bones and repositioning them to close this deformity. Imagine cutting off the top of an A-frame house; that is exactly what an "open sky deformity" is. The vertical beam... more

Jeffrey Weinzweig, MD

Chicago Plastic Surgeon

Dorsal Hump Removal Rarely Possible without Bone Cuts

Your nose is a shell. In other words, it is hollow. It is not like a solid block of wood that can simply be sanded down into a smaller shape. The thickness of the "shell" is only a couple of millimeters. If your hump is very very small, it may be possible to shave that down without violating the shell. If your hump is that small, you probably don't need a rhinoplasty. When a hump is taken off of the dorsum of the nose, it leaves what is... more

Doctor's Website

Louis W. Apostolakis, MD

Austin Facial Plastic Surgeon

Rhinoplasty to achieve a reduction of a small dorsal hump/bump.

Presuming that there is a small nasal dorsal bump, rasping (or shaving) it can be quite successful. However, it is important to distinguish between a bony vs cartilaginous hump. While both may be treated easily, you must be certain to address both if needed. I have seen many noses where the plastic surgeon only removed the bony bump and failed to correct the cartilaginous portion. This obviously would result in an undesirable outcome. That being said, removing only the hump certainly may... more

Doctor's Website

Jon E. Mendelsohn, MD

Cincinnati Facial Plastic Surgeon

Filing the bump on your nose down

A "finesse rhinoplasty" was initially described years ago, and does not involve moving the bones. In my practice almost half of the patients I treat, simply require reduction of a small bump with a file. The recovery is short but you do need an exam before proceeding. Call for an appointment.

Darrick E. Antell, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Clear vision of what you want

It seems that you have a very clear vision of exactly what you want in a change of your nose. Your chances of getting exactly what you are looking for are, in my opinion, very high. Stick to that plan. It is very refreshing to have you know exactly what you want to change and how much you actually like your nose and your personal body image. Best, Tal Raine MD

Talmage J. Raine, MD

Chicago Plastic Surgeon

ASAPS ASPS

Rasping a small dorsal hump during a rhinoplasty may not require breaking

Unless a nose needs narrowing or unless the dorsal hump is large, it is probably better to avoid breaking the nose. So this is in line with your wishes. Recovery is shorter and bruising is also usually much more limited if fracturing can be avoided.

Roger J. Oldham, MD

Bethesda Plastic Surgeon

ASAPS ASPS

Dorsal Hump Removal

For minimal bony/cartilaginous humps a conservative reduction of the hump without fracturing the nose is a perfectly acceptable approach. This all depends upon your goals and preferences as well as what the surgeon feels the anatomy will allow. Not everyone can get a good result from this approach but a small hump may be removed without going through the trauma of the nasal fracturing. What you want to hear from your surgeon is that the nose will not look overly wide from the front view. more

Jon F. Harrell, DO

Miami Plastic Surgeon

ASPS

Filing a Dorsal Hump

Every hump is different and so the technique which is best suited for your hump must be individualized. Some humps are bone only whereas others are cartilage only or a combination of cartilage and bone.

Anil R. Shah, MD

Chicago Facial Plastic Surgeon

Filing down small nasal hump

Filing is a perfectly good way to treat an isolated small dorsal hump. An experienced surgeon will be able to give you advice as to the need for additional modifications after he sees you. Your desires should be kept in mind, but his experience can keep you out of trouble.

Randy J. Buckspan, MD

Austin Plastic Surgeon

ASPS

Small dorsal hump

Usually a small hump can be address with closed rhinoplasty, alone. However, this can affect other areas of your nose and I would trust your surgeon's advice concerning these other areas. The key is to choose a board certified plastic surgeon with a passion and eye for rhinoplasty.

Dustin L. Reid, MD

Austin Plastic Surgeon

ASPS

Rhinoplasty Bumps

Most mild bumps can be addressed through a closed approach using rasps or files. Often times, there are other features which may need to be addressed as changing one feature of the nose affects the tip position and the width of the nasal width.

James Newman, MD

Bay Area Facial Plastic Surgeon

Dorsal Hump Reduction

Certainly you can reduce the dorsum via a closed approach. How extensive it is just depends on how much needs to be reduced. Sometimes the bone needs to befractured, but other times simply filing the bones and cartilage will work.

Christopher V. Pelletiere, MD

Barrington Plastic Surgeon

ASPS

Simple hump reduction may be fine for small hump - it depends on your nose

That may be very reasonable advice. If your hump is very small then a simple hump reduction is often adequate. If the hump is large then removal of the hump will leave a flat appearance to the bridge of the nose. This is counteracted by gently fracturing the nasal sidewalls and bringing them inward to correct the flatness. Rhinoplasty can be complex and making a change to one part of your nose can have visual effects on other areas. Consult an experienced Rhinoplasty specialist, and be... more

Doctor's Website