I'm looking for a subtle but effective change which will provide a smoother, more refined appearance, however still maintaining the characteristics of my nose (I don’t mind the hump, but possibly smaller?) Not looking for a drastic change, therefore would rasping alone be sufficient in achieving a smoother bridge? I like the front profile and wouldn't want the bridge narrower than it already is. In your opinion, what would need to be done? I'm trying to be as realistic as possible. Thank you.
Is Nasal Rasping Enough or Would I Need Another Procedure Done? (photo)
Doctor Answers 8
Subtle Rhinoplasty, is Rasping Alone Enough?
The less drastic change you desire, the more that rasping alone will suit you. Rhinoplasty is an art like sculpting. Everything is relative in the harmony of your nose. You should consult with multiple rhinoplasty surgeons and find one that you feel comfortable with, whom you feel understands your rhinoplasty goals. An honest surgeon will let you know if your goals are realistic. Good luck and be well.
Rasping a nasal hump
Most of the hump on this nose is cartilaginous which does not lend itself to rasping. Excess bone has to be rasped. However, rasping alone would not be sufficient enough to give a natural looking nose. It is also important to address any tip fullness and any depressor septi function that may be present.
Nasal Rasping Sufficient for Nasal Reshaping?
Looking at the photo provided, I would say you would likely need more than just rasping of the bridge. You probably would need to have the nasal bones moved inward at the same time to maintain proper balance of the bridge. Consult with a rhinoplasty expert so they can give you a more in-depth explanation.
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When a nasal hump is removed, generally more than rasping is necessary
The key to rhinoplasty is balance and maintaining structure. Humps are often removed with rasps but it's like taking the top off a pyramid. There will be a gap if the bones are not "closed." That is when osteotomies or "breaking" the nose is necessary. This is more gentle than it seems and doesn't make the nose less stable, it yields a superior result. You should discuss your goals with a rhinoplasty specialist. I find computer imaging can also help a lot with this dialogue.
Nasal rasping a hump.
This probably will not be enough and you should see a rhinoplasty surgeon who can feel your nose and discuss your goals.
Dorsal hump, rasping, open roof deformity
With the degree of dorsal hump that you have rasping alone would be inadequate. When rasping is performed the bone is sanded down to the desired level. If this were to be done in your case it would create a open roof deformity where the dorsum of the nose would be wide and squared. A more accurate and reproducible means to reduce your hump would be excision with osteotomies and nasal fractures to close the defect created in the dorsum by removing the hump. Unfortunately, there is seldom an easy way to perform a rhinoplasty.
Nasal rasping wil not be enough to refine your dorsal hump. More than likely you will need the bones infractured to prevent the nose from looking flat after the bump is shaved.
Smaller Bridge through Rasping
Rasping a dorsal hump that is smaller may not require osteotomy, but larger humps that are rasped may need ostetomies to close the "open roof" deformity. This will narrow the nose a bit. However, there are ways to maintain the width of the nose to whatever specification you may have in mind. Consultation with a board certifed plastic surgeon of your choosing can easily sort this out.