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Is It True That the Tip of the Nose Falls if You Remove a Bump on the Bridge?

I had a consult with a doctor who only does rhinoplasties and he informed me that if I wanted my bump removed then he would need to elongate the tip as well. His reasoning was that anytime a bump is removed from the bridge, the tip will also fall. Please let me know if in your experience if this is the case. I would prefer a closed surgery and because of this elongation of the tip, he recommends an open surgery.

Doctor Answers (12)

Removing bump on bridge and affect on nose tip

+1

That is incorrect.  When removing a bump on the bridge, the columella tends to bow downwards and give an illusion of a lengthened nose.  After removal of the hump, attention is directed to reduce any columellar show to keep the nose within proportion.  Columellar show is a telltale sign of having had a rhinoplasty.  Simple hump removal can be done quite easily through a closed rhinoplasty without any elongation of the nasal tip.  Open rhinoplasty will extend the healing time with more swelling, bruising, and has other associated complications.  


Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Does Nasal Tip Fall with Hump Removal?

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The tip will not fall if only a hump is removed during a rhinoplasty. However, tip position may have to be altered to maintain good nasal proportion. Your tip does appear to be wide and poorly defined; changing contour and position may be beneficial. I recommend you have an open approach if that is what your surgeon recommends - I have used the open technique in some noses for over 30 years with very satisfying results.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Tip position after removing nasal hump

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Three things can happen after removing a nasal hump. The tip can remain in the same position which is most common if the surgeon does not affect the supporting mechansims of the tip of the nose. Second, the tip can rotate upward if the hump reduction goes all the way down to the tip and includes the cartilage septum at the anterior septal angle. Third, the tip can only fall if the supporting attachments to the septum and the upper lateral cartilages are disrupted allowing the tip to fall. So the bottom line is the tip position is dependent upon what the the surgeon intends to do with your nose not the hump reduction itself.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

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Will the tip droop after removing bump from bridge

+1

In general, taking down a bump on the nasal bridge shouldn't cause the tip to fall. Depending on the surgical approach, though, the tip can become less stable and require extra support to maintain it's current position.

One thing to consider with removing a bump on the bridge is the matter of preventing pinching of the middle third of the nose as the nose heals. Spreader grafts can be placed in this case to prevent this from occuring.

 

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Nasal tip after dorsal hump removal

+1

In general removal of the dorsal hump should have minimal effect on the nasal tip.  Sometimes the tip may need support from cartilage grafts with an open rhinoplasty technique.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 5 reviews

Tip support by the bridge of your nose

+1

Believe it or not your surgeon is correct. The amount of tip support given by the bridge of your nose can vary from patient to patient. Depending upon the strength of the tip cartilages you may or may not need to have soemthing done to the tip of your nose to either hold it in position or even raise it. Your tip appears to be a bit droopy already as it looks to be hanging down just at the end of the bridge of your nose. Even if you didn't ant to change the appearance of the tip itself, i agree that you would need a graft to support the tip, called a columellar strut. If this is all you need it can be done using a closed approach. Perhaps your surgeon has plans to some other things though with the shape of the tip cartilages, in which case an open approach is certainly justified. Good luck.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 23 reviews

Concerns about nasal hump and recommendation for an open approach

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Removal of a bump on the nose does not affect the tip particularly the size that you have. However, in order to obtain an aesthetically pleasing nasal appearance, other changes usually need to be made and this often includes the tip.

In order to obtain the desired changes in a predictable way, an open approach is the preference of most rhinoplasty surgeons. This also lowers the incidence of requiring a secondary procedure to further improve the outcome.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 20 reviews

Nasal tip effect after hump reduction.

+1

Generally, the tip does not need to be elongated following removal of the nasal hump.  It does however need to be re-supported in order to prevent it from drooping over the course of healing.  Rhinoplasty can weaken the support of the tip so regardless of the maneuvers performed, the support needs to be re-established. This is not the same as making the nose longer.  As mentioned earlier, bringing the hump down, the nose will appear longer.  This can be modified using other maneuvers to make the nose look balanced. 

Amir M. Karam, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 77 reviews

Tip

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The nasal tip needs to and should have support of it's own. Removing the hump should have no efffect on the tip. However tip work may be desired as well

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

Is it true that the tip falls when hump is removed with a Rhinoplasty?

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Is it true that the tip falls when hump is removed with a Rhinoplasty?  No, actually the opposite is true that the nasal tip will often appear rotated upward after the hump is removed and this needs to be taken into account in order to prevent a nose that looks overly shortened when performing the Rhinoplasty.  The hump should be removed first then decide if and how much the tip needs to be rotated, IMHO.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.