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Fixing the Dorsal Hump on my Nose Without an Osteotomy

I would like it filed down slightly and would like to avoid an osteotomy. I am fine with other aspects of my nose and am not looking for a dramatic change. I just want it filed down so that I have a more attractive nose. Based on the photo I have included does this seem like a reasonable request?

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24 Doctor Answers | Asked by 7841anon in California

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Removing your dorsal hump would likely require osteotomies.

You appear to be an excellent candidate for Rhinoplasty Surgery, based on your profile photo. Your dorsal hump is bony at the top, and mostly cartilaginous from your mid-bridge down. Your tip is a bit overprojected, and your nose is a bit long. You would likely benefit from hump reduction, along with nasal shortening, and tip deprojection and rotation. Osteotomies would be necessary to narrow your nose on the frontal view: your bridge will widen after the hump is removed. Osteotomies cause... more

Eric M. Joseph, MD

198 reviews

West Orange Facial Plastic Surgeon

www.ericmjoseph.com

Nose hump reduction often needs bone repositioning - this is safe and time-tested for rhinoplasty

Hump reduction without osteotomies is like having an offense without a defense - the two go hand-in-hand. Doing the hump reduction alone will cause the dreaded "open roof" deformity, a problem you don't want to have. To defend against this, osteotomies (controlled breakage of the nasal bones) and "infracturing" (repositioning the bones inward) prevents the open roof from happening. Sure, with thick skin, a tiny hump can be improved without osteotomies, or... more

Removing dorsal hump without an osteotomy

Sometimes it is possible to reduce a small dorsal hump without performing an osteotomy. Determining factors include the size of the hump, the amount you would like it reduced, and the thickness of you nasal bones. From your photo that you submitted, I would think it would be quite unlikely that a satisfactory result could be obtained without an osteotomy. You should listen to your surgeon and go ahead with what he or she suggests in order to get the best result. more

Dorsal hump - no osteotomies

It would help to see a front view but in some cases where the nasal walls are very vertical, it is possible to take down a dorsal hump without osteotomies. In fact, I just did this on a patient last week and she had a beautiful result! However, you will have to be more conservative with how much of the hump is taken down. I would recommend you seek consultation with an experienced rhinoplasty surgeon to discuss what your options are and openly discuss your desire to... more

Can a Nose Hump be smoothed WITHOUT Breaking the Cheek / Nose Bones

Regarding: "Fixing the Dorsal Hump on my Nose Without an Osteotomy - I would like it filed down slightly and would like to avoid an osteotomy. I am fine with other aspects of my nose and am not looking for a dramatic change. I just want it filed down so that I have a more attractive nose. Based on the photo I have included does this seem like a reasonable request?" Minor dorsal nose humps can be reduced without having the break the nasal bones and narrow the top. But... more

Removing dorsal humps often require osteotomies

When taking significant humps off of a nose, a flat top nose or an open roof deformity will result. Osteotomies close the flat top nose and create nice dorsal aesthetic lines. In the majority of cases osteotomies do have to be performed when removing bumps off of the bridge of the nose.

Dorsal rasping of nose

Most rhinoplasty surgeons would advise you to have the nasal bones fractured after reducing your hump - assuming you wanted a significant reduction. If you're looking for a minimal reduction a consideration would be minimal reduction of the bridge with grafting of the radix of the nose (the part of the nose where it blends into the forehead). Another option would be injection of a filler into the radix. During a consultation these are the kinds of things that can be discussed.... more

Fixing Dorsal Hump Without Osteotomies

Hello, It really depends on your individual circumstances. Based on your photo, it appears the hump can be taken care of but you would most likely need to have osteotomies (narrowing of the nasal bones) performed. Failure to narrow the nasal bones may result in what we call an open roof deformity. When your surgeon shaves down a hump, this may leave an opening, which is located in the roof of the tunnel. Osteotomies would be performed to push the bones inward. In effect, this will... more

Rhinoplasty is Complex

Rhinoplasty is complex. You cannot just address one area without it affecting another area. It sounds easy to say "just take off the hump but leave everything else the same." However, if you take off the roof (hump) of your nose, then you will have an open roof. To close the roof, you need osteotomies so the bones can be pushed back together. Good luck with your procedure.

Why are patients afraid of osteotomies?

I hear this question almost every day---can you fix my nose and NOT break the bones? The idea of osteotomies is very upsetting to many patients, but it shouldn't be. Patients are generally under anesthesia for surgery, will not feel the osteotomies, and will heal in 1 week, regardless of whether or not they receive osteotomies. In your case, you need hump reduction and ostetomies, as well as a graft to the radix (bridge). I would suggest consulting with a qualified... more

Can a dorsal hump be reduced without an osteotomy

Please look at your nose from the base...it looks like a pyramid, right? What happens when one takes off the top of a pyramid...the pyramid looks wider. This is an optical illusion. Looking at your profile, I believe the amount of dorsum which must be removed is large enough so that your nose will look very wide from the front. You should not be afraid of osteotomies. It is a very common procedure done thousands of times a year, with minimal complication (if done b more

Improving Dorsal Hump without Osteotomy

No, generally it's not possible as other plastic surgeons have stated. Small bumps may be rasped down, but larger bumps require more bone & cartilage reshaping. Bone reshaping is performed with osteotomy, or controlled cuts in the nasal bones. Bumps on the nose are made of cartilage and bone. Typically, bumps are reduced, and occasionaly parts of profile are filled in to match the bump. Speak with a rhinoplasty surgeon to perform a comprehensive evaluation and to help determine... more

Avoiding Osteotomies With Nasal Hump Reduction

In my opinion I don't think it is likely you will be able to avoid osteotomies after reducing your dorsal hump. Most patients and rhinoplasty surgeons would likely aim to bring down your bridge a fairly moderate amount. In fact, many surgeons would also agree that your tip needs to be brought closer to the face. When you rasp the bridge down to such a degree, you really do need to perform osteotomies in order to maintain an appropriate width as seen on your frontal view. If not, you... more

Balancing Act

Performing rhinoplasty is a balancing act. I view the nose in terms of proportions. If one aspect of the nose is altered many times the other portions of the nose become disproportionate. Example, If only your dorsal hump is removed then on the frontal view the nose will appear wider WITHOUT osteotomies. Additionally, I believe that if you only remove the hump on your side view your tip area would look larger and more projecting. Listen to the recommendations... more

Removal of Hump without Osteotomies

Your nasal hump can be minimally reduced if you don't want do osteotomies. To achieve a straight dorsum (or profile line) you will have an unnatural wide bridge unless the osteotomies are done. See an experienced surgeon who will clarify your options and establish expectations.

Richard W. Fleming, MD

9 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

I think you would be happier with the results if ostetomy is performed.

Although I understand your desire to avoid osteotomies, "filing" of the hump withour osteotomies would leave what we call an "open roof deformity" that will give you a flattened and unnatural appearance. You would be happier with reshaping of the whole nasal dorsum. You could rasp the dorsum a small amount without obtaining an open roof but I don't think you will see much difference.

Trust Your Surgeon's Advice

It is not uncommon for a patient to have misgivings about certain elements of a surgical procedure. However, in Rhinoplasty, it is far better to follow your Surgeon's advice and to allow him/her to "do the right thing" when performing your Rhinoplasty; it would be far better to do nothing than to try to dictate the specific maneuvers in your surgery. In your specific case, reduction of the dorsal hump without osteotomies will create a flat shelf-like appearance on... more

File nose only

Not a chance with your nose! Just from the profile it looks like you have too much of a dorsal hump. When you rasp it down it will look very wide and in order to provide nice nasal lines, you would need osteotomies. Do not focus so much on limiting your surgeon's ability to give you an excellent result.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Augment the radix, instead of shaving the dorsal hump

7841: Your profile shows a straight dorsum with a low "root" or radix. The tip is well defined and the nasolabial angle harmonizes with your face. Prior to contemplating rhinoplasty, why not augment the "dip" above the "bump" with a Hyaluronic acid. While the result will not be long lasting, it may allow you to "try it before you buy it". If you decide to reduce the dorsal hump, I think that an osteotomy would be essential as... more

Lavinia Chong, MD

22 reviews

Orange County Plastic Surgeon

www.chongmd.com

You will need osteotomy

You have too much dorsal hump and reduction of the nasal bone will leave flat dorsum. Please let your plastic surgeon do what needs to be done to get the perfect result. I would like to know the reason for opposing the osteotomy.

Kamran Khoobehi, MD

28 reviews

New Orleans Plastic Surgeon

Fixing the Dorsal Hump on my Nose Without an Osteotomy

Thanks for the photo side view. Your answer isssssss NO! Removing hump will leave an "open roof" deformity that can be closed by osteotomies. Seek in person opinions.

Fixing a dorsal hump without osteotomy.

Removing the hump will leave the sides of the triangle too far apart and that is why you will need osteotomies. This is not painful and will give you a better result. See an experienced rhinoplasty surgeon to discuss this.

Toby Mayer, MD

7 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Leave it up to the doctor

You are not an expert in rhinoplasty, tell the doctor what you want and then don't tie the experts hands. Let him or her do what is needed. You will be asleep and nothing will hurt no matter what is done.

Nasal humps can be reduced without fracture

It is true that in some instances it is possible to reduce the hump on the nose without completing nasal fractures. Often though hump reduction will produce a flat area on the bridge much like cutting off the top of the letter A. The purpose of the fracture is to adjust the width of the bridge, and to straighten the nose if needed. These fractures can be done very gently, with multiple perforations in the thin bone, and a 'greenstick' fracture to flex the bones into position. I think... more