Rhinoplasty: Q&A
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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?
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51 Doctor Answers |
Asked by
Star05
in Neport Beach, CA, USA
+3
Dorsal hump
A small dorsal hump can be approached through a closed rhinoplasty technique. The dorsal hump can be addressed other by filing down the nasal bones for trimming the dorsal cartilage. It the hump is very small and is largely due to excess dorsal cartilage then nasal bone osteotomies may not be required.
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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...
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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.
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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...
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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...
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Rhinoplasty Surgery & Correcting the Dorsal Hump
Closed rhinoplasty can often be utilized to correct small isolated dorsal humps. In most cases, these humps consist of both cartilage and bone. Correction involves filing the bone and shaving the cartilage. In many cases, infracture of the nose can be avoided when nasal humps are small. When nasal humps become larger, fracture of the nose is necessary to avoid secondary aesthetic issues.
It’s essential that a careful analysis of your nose be undertaken prior to surgery. Each patient has...
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Closed rhinoplasty for dorsal hump removal
This approach may work very well. Each individual is different. One may need cartilage trim. One may need in-fracturing. Best to see an experienced rhinoplasty surgeon. Take a look at the before/after photos. Visit with a few. Ask your questions. Together, you should be able to garner a plan to achieve your goals.
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Dorsal hump rhinoplasty
It depends on the size of the hump. If it is small, then you can simply file this down without external incisions. However, if it is larger, you may need osteotomies. That portion of the nose (dorsum) is shaped like a tent, if you take off of the top part, the sides will no longer be in contact with the top and it will look like a trapezoid, leading to a broad appearance of the dorsum and an "open roof deformity". The osteotomies allow the nasal bones to come in...
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Definitely yes
Small or large dorsal humps can be reduced using closed rhinoplasty techniques. However, even with many small dorsal humps, the bones may need to be narrowed because once the hump is removed, the dorsum will appear wider and you may see and feel sharp edges of the nasal bones. The surgeon should be able to tell you by looking at the size of your hump if he/she would need to break the bones to make the dorsum narrower. Further more, even with small humps, spreader grafts...
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Removing a Bump (Dorsal Hump) without Breaking the Nose Bones
Yes, this is possible. A closed approach (sometimes called an endonasal rhinoplasty) can be used to gain access to the nose bones from inside the nose. Then, the areas of concern can be filed (using an instrument called a rasp). As long as this does not create a flat bridge or an open roof (where the two sides of the nose don't meet in the middle), so further work on the bones is required. Best of luck moving forward!
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Dorsal hump and closed rhinoplasty.
A minor dorsal hump can usually be reduced with a closed rhinoplasty approach. However, there is no guarantee that your bones would not have to be brought in with an "osteotomy." If you think of a hump as the top of a mountain, then imagine the cap of the mountain taken off...you are now left with a wider looking mountain. In this situation to avoid a wide looking dorsum or nasal bridge then the bones will have to be brought in. It all depends on the architecture of your nasal bones...
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Should work
Yes, open or closed does not matter so much for this. However, if it is open, the surgeon can see the osteotomies (the cuts in the bone) and make sure the edges are smooth. Also, make sure that all you want is a hump reduction. Ask the surgeon to morph the images, and make sure that is all you need. Once you see the morphed image, you might realize that perhaps the tip of your nose over or under projects. Just double check.
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Rhinoplasty San Diego
It is possible that if you only have a very small bump, the procedure could be done just by filing down the bridge. This keeps the procedure simple and recovery would be quicker. Usually when the bridge is reduced the nasal bones need to be broken and narrowed to avoid a wide bridge, especially if the bump is a large one. If you trust your surgeon's expertise, go with his or her recommendation.
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Reducing a dorsal hump
Yes, I have many patients that have been treated with closed rhinoplasty with dorsal hump reduction. In cases where the hump is small, then it is very possible that your surgeon might not need to perform osteotomies to break the nasal bones. I have seen this be successful many times, but you should be sure your plastic surgeon has plenty of experience with these techniques. Many younger surgeons never received training to perform closed rhinoplasties. Good luck.
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Filing Down the Dorsal Hump
Of course the dorsum of the nose can be filed down but complete evaluation of the nose is needed to see if additional work will be required. If the nose is widened by the filing down then osteotomies must be done. If the cartilage is also too large they will be need to be reduced with a knife.
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Filing down the Dorsal Hump
Dorsal humps are made up of bone superiorly and cartilage inferiorly. Simply filing (rasping) will only address the superior, boney portion of the hump. The inferior, cartilaginous portion needs to be removed by cutting it with a scalpel or scissors. This can be done through a closed approach or an open approach. I prefer open as the visibility is far superior and I can be much more precise and do a better job.
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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.
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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...
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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...
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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)...
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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...
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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.
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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...
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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...
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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...
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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...
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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.
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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
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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.
Bethesda Plastic Surgeon
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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.
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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.
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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.
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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.
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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.
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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.
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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...
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Filing down the dorsal hump only
It is difficult to predict for sure whether you would require other procedures or not. However, you should recogize that when you file the hump down only, it is possible your nose may appear slightly wider. Some people perceive this as a positive thing and some people perceive this as a negative thing, but that's the reality of altering just the hump. The nose is a 3D structure and, as such, changing one part of it can result in a change in overall appearance, to some degree. Ultimately,...
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Small hump can be fixed via closed rhinoplasty
Reducing or smoothing a small nasal hump is a simple procedure that can easily be done via a closed rhinoplasty. A very small hump will likely be taken care of with simply rasping the bone down. Any cartilaginous contribution can also be easily removed. However, the final determination whether nasal bones need to be cut can only be made at surgery because there's always a risk an open roof deformity results after the hump is shaved down. If this happens, the nasal bones must be cut to...
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Correction of a small hump on the nose
Correction of a small hump on the nose can be as simple as just filing the area down gently with a rasp under local or IV anesthesia. However, in some patients if it is a larger hump a flattening effect to the dorsum may result called an "open roof" and this might require breaking or infracturing the two nasal side bones to close the area that was filed down to prevent a flattened appearance. Even if the additional surgery is required it is considered minimal and shouldn't take the...
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Sculpt the dorsal hump, dont break it
Hi Star
Yes a dorsal hump can be approached effectivly through a closed approach. If it is mild then it may not have to be "broken." if you want just a small amount reduced it can be done with a rasp, which looks much like a file. Or what I have had great success with is using a rotating "burr." It is an instrument that precisely shaves down and sculpts down the nasal bone to a very smooth finish. If the hump is very large then it can be approached also through a closed...
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That depends on what your nose looks like and the anatomy of the nose
If you have a small hump and filing the hump does not cause your nose to be too wide after the hump is taken down, then you can avoid other procedures. Most of the time, however, the hump will create an open area near the area of where the hump was located which will need to be closed. To close the open area, oftentimes you need to break the nasal bones to fit the new level of the nasal bridge you were desiring. I would be prepared to undergo something a little more involved than you were...
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Rhinoplasty and Humpectomies
The nasal hump is composed of bone and cartilage. Most small humps can be reduced with rasping and removal of cartilage using an endonasal (closed) approach. Most good rhinoplasty surgeons will assess the profile and determine if - after removing the hump - osteotomies are require to narrow any flatness on the dorsum. It is important to remember - there is no "simple" rhinoplasty - even a simple hump reduction may require osteotomies and can develop scar tissue during the...
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Shaving down the 'hump' only may create a flat appearing nose.
Shaving down the 'hump' only may create a flat appearing nose if you have a significant hump. This may create an 'open roof' deformity. Many patients benefit from 'breaking' of the bones following hump reduction to create improved nasal harmony.
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Possibly!
A nose is a three-dimensional object in the shape of a three sided pyramid. If you adjust only one aspect of the nose, you may create disharmony. In your situation, unless your bump is extremely small, shaving it down may actually cause the middle one-third of your nose to look wider. This will give your nose a more globular, indistinct look.
Your profile will be better, but people looking at you head-on will see something that just doesn't fit. In this situation your surgeon then has...
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Avoid the "open roof" deformity
As one of my colleagues below touched on, the problem with "only" rasping down the nasal bones is that the nasal bones and cartilage are quite thin--a few millimeters, really--so that anything more significant than a tiny hump will require rasping right through those thin plates of bone and cartilage. This creates what is known as an "open roof" deformity, which can become unsightly over time. To close the open roof requires cuts in the bone where the nasal bones meet the...
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Probably you can have what you describe
Without photos of your nose, it is impossible for any of us to comment specifically on the question you ask. However, IF all you need and want is a conservative dorsal hump removal, that should be possible through a closed approach.
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The Subtle Rhinoplasty, or the "Dr. No-Name" Nose Job
Hi Star,
Sounds like you need a subtle rhinoplasty. I like to cal it the Dr. No- Name nose job because in the past, there were surgeons whose rhinoplasty patients all came out looking so alike that the "look" became the egocentric "Dr. Smith" nose job. Today, cookie cutter noses are no longer acceptable. Each nose is different, as are the desires and goals of each patient. Therefore, sometimes all that needs to be done is "a little filing down of the hump"....
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Yes, if the hump is very small.
To Star05,
The nasal hump is usually made up of bone and cartilage. So what you do is rasp down the bone and trim the cartilage. If the hump is very small, nothing else needs to be done.
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Yes, depending on your anatomy
Bear with me with this description:
If you think of your nose as a teepee. You have nasal bones on either side leaning in as the wall of your teepee, and you have your septum as the pole in the middle of the teepee holding things up.
/l\
/ l \
The peak of the teepee is the dorsum of your nose - what you see as a hump. As you remove more and more of the peak of the teepee, the remaining portion of your nose looks flatter and wider.
/l\ (removed)
/ l \ (left behind)
If it is too flat...
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Englewood Plastic Surgeon
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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"!
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Nasal hump removal
If it is a very small bump on the nose, then sometimes filing it down is all thay you would need. If it is a large bump, then when it is filed, it sometimes looks a bit flat and then the bones need to be osteotomized( broken methodically) to reset the normal pyramid shape of the bones.
Steven Wallach, MD
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