I'm African-American and thinking of getting rhinoplasty. I have a slightly wide bridge and a slight hump on my nose, which I hate. I want to slim the bridge part of my nose without tip work, but i also dont want to have my nose broken to slim it. Is it possible to just shave down the bridge part of my nose without breaking the bone (osteomy), and still make it look natural? And if the bone is broken, will it ever heal enough to become as strong as it was before the surgery?
Can a Wide Dorsal Part Be Slimmed Down by Shaving It Down Without Breaking the Bone?
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African American Rhinoplasty
Yes you can sheave down your hump without osteotomies. This will bring down your bridge but it will still be wide. If you have osteotomies, this will narrow your bridge. Yes, over 3 to 6 months the bone will heal and be as strong as before. You may also want to consider a small implant to narrow the bridge.
I have a website dedicated to African American rhinoplasty below. My surgical techniques are described as well as many before and afters.
Narrowing nasal bridge and improving nasal bump
Yes, a bump on the bridge can be shaved down without doing bone breaking. This would probably give the effect of widening your bridge, if anything, though. Concurrent controlled bone fractures to narrow the bones can help with narrowing the appearance of the nose from the frontal view.
Performing these osteotomies doesn't usually change much in the way of recovery. There's a greater chance of having bruising after surgery as a result, though the pain and swelling are much different. The bones are set after about 6 weeks and you aren't any more likely to fracture your nose as you were before surgery.
Slim nose during Rhinoplasty may require osteotomies
I have performed Rhinoplasty for over 20 years and things are never as simple as they may seem. The bridge can be narrowed by rasping the sides, of the nasal bones or by lateral osteotomies (breaking the bosnes) with the osteotomies capable of moving the bones more than rasping can achieve.
Removing the dorsal hump, is another story. Because the bones sit on the face as a hollow pyramid, the nasal bones are only a couple mm's thick. That means, if your hump is larger than that, rasping it down will simply remove the top portion of the nasal bone creating an open roof deformity...which should be closed by bringing the edges of the nasal bones back together using a lateral osteotomy.
IMHO, have a couple of consultations with experienced Rhinoplasty surgeons. Tell them your desires and limitations (no bone breaking) and then listen to what is reasonable to have done or not. It's quite likely that you would need to have your nasal bones broken (osteotomies) just to properly remove the dorsal hump.
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Shaving v. breaking the hump
often times reducing the hump leaves a wider appearing nose with a central plateau, this may even have an indentation or irregularity known as an "open roof". osteotomies or a controlled break along the side of the nose allows for two things, 1. narrows the bridge and 2. closes an open roof. so don't worry about the osteotomy weakening your nose, it will be plenty strong after 2-3 months.
Rhinoplasty is a complex procedure and is not a simple as "shaving off" the unwanted areas. Attention must be paid to the underlying anatomy and the support and structure of the nose. In minor cases, the dorsum can be lowered by shaving alone. However, you need to be careful since that can actually make the nose appear wider if the osteotomy is not also performed. Additionally, if much bone is shaved, then you may be left with an open roof deformity if the osteotomy is not performed. If you are seeing a board certified and qualified surgeon, then you really need to trust their opinion on what needs to be done during surgery to achieve your goals. If you try to dictate what portions of the procedure can and cannot be done, then you may not get the result that you are looking for.
Can Nose be Reduced without breaking the bones?
There is a small group of patients who can get a modest reduction in the bump located on the bridge of their nose without necessarily fracturing the nose. For most patients however, this maneuver widens the bridge of the nose and fracturing of the nose allows the bridge to be narrowed in an aesthetic fashion. Rasping has limited ability to narrow the bridge in my opinion. Nasal strength will return close to preoperative levels relatively quickly after surgery. An experienced nasal surgeon will be able to present you with your best options. Best of Luck Dr Harrell
Shaving Down Dorsal without Breaking Bones
Sometimes, but if a lot of the widened dorsum is to be removed, usually
osteotomies will be indicated.
Narrowing wide nasal bridge without breaking the bone
It is impossible to narrow the nasal bridge without breaking nasal bones. A very small hump can be removed from the bridge without breaking the nasal bones. Removing a moderate to large hump will require osteotomies to prevent the square top or open roofed nasal deformity. Although the bones do heal and are fairly strong after the rhinoplasty, they do heal by fibrous union and are not quite as strong as they were prior to the rhinoplasty. This only matters if you get hit quite hard from a sporting injury.
African American rhinoplasties also need to be individualized.
In general, breaking the nose seems dramatic but is not a big deal. It does usually cause mild to moderate bruising, but for a nose with a wide bridge, there is no other way to narrow the upper part of the nose. For many African American rhinoplasty patients, cartilage grafts to the tip and bridge will raise the height of the nose, making it appear less flat and more refined.
Alternatively, some patients are candidates for non-surgical rhinoplasty to augment the tip and bridge with injectable filler. Make sure you find a surgeon familiar with rhinoplasty in general and African American rhinoplasty specifically. I hope this helps.
Poetry in motion
A small dorsal hump can indeed be shaved down without having to break the nasal bones. Narrowing the dorsal width by shaving without osteotomies is less likely. Shaving down the dorsum generally widens the bridge of the nose even further. I would recommend consultation with a plastic or facial plastic surgeon for a more complete evaluation and discussion of your options. Good luck!