Is It Necessary to Break the Nose to Fix Small Bump?

I had my consultation with a surgeon about my Rhinoplasty. I only have a small bump but just a little longish nose. He said he would have to break the bone. But is it not just for when you have large humps that the nasal bone breaking is necessary? I am really freaked out. Is that necessary or avoidable? Please help me.

Doctor Answers 13

To Remove Small Nose Bump Breaking Bones May Be Necessary

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Thank you for your question. Please do not "freak out".

An experienced Board Certified Plastic Surgeon can advise you after examining you.

In some cases a simple rasping or filing of the nose bump is all that is required.

However in most cases, the rasping down of the nose bump results in the top of both nasal bones showing through the skin. This is called an "open roof deformity."

By breaking the bones, the bones may be brought together to recreate a smooth appearance to the top of the nose.

This also prevents the nose from looking wider after removing the hump.

This is a straightforward part of the standard Rhinoplasty procedure and should not alarm you.


Removing nose bump without breaking the nose

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Thank you for your question.

It is possible to remove the bump on top of your nose without breaking your nose.  This requires reducing the bone and cartilage on the top of the nose in order to remove the bump.  However, it is important to note that if the bump is more than just a very small one, by reducing the bump on the top of the nose you require the bones along the side to be broken.

The reason for this is that once the top of the nose has been reduced it leaves an opening where the bones no longer join because the top of the nose has been taken off.  This is sort of like taking the off the top of the peak of a tent.  With this open roof deformity, breaking the bones is necessary in order to restore the top of the nose.

Cory Goldberg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 48 reviews

Breaking the Nose During Rhinoplasty

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"Breaking the nose" is technically called an osteotomy. This is a small part of a rhinoplasty used to narrow the nasal bones if the nose is wide or if a bump is taken down leaving a gap between the bones. 

The he video animation attached explains this part of rhinoplasty well. 

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon
4.9 out of 5 stars 71 reviews

Removing a Hump and the Need for Osteotomies (Surgically Breaking the Nose)

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One of the most common reasons that patients seek rhinoplasty consultations is to learn about dorsal hump reduction. A dorsal hump is comprised of bone and cartilage. To remove the hump, the rhinoplasty surgeon files down the bone and trims the cartilage to the appropriate height to give the profile the desired contour. For an experienced rhinoplasty surgeon, this is a very straightforward procedure. For large humps it is necessary to surgically break the nasal bones (called osteotomies) to close a gap on the top of the bridge (an "open roof" deformity) that results when the hump is removed. However, this is something that needs to be evaluated on a case by case basis.

It is possible to correct one isolated problem -- such a a dorsal hump -- without having to change or disrupt other parts of the nose. The goal of any rhinoplasty is to produce a nose that looks natural and functions well.

To get a better understanding of what your nose would look like after surgery, your prospective rhinoplasty surgeon should be able to show you before and after computer simulations. Many rhinoplasty surgeons use computer imaging, and recently 3D rhinoplasty imaging has become available. This allows patients to preview how their nose might look after surgery from any angle.

C. Spencer Cochran, MD
Dallas Facial Plastic Surgeon
4.7 out of 5 stars 149 reviews

When to break the nose in rhinoplasty

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If your bones are wide, you might need them broken to narrow them for the best result. Also, if you have a large bump, taking it off can leave a flat bridge called an "open roof" and won't look good unless the bones are narrowed.

Even if you do need it, it isn't really a big deal for an experienced surgeon and the recovery is about the same just with a little more bruising. Maybe you need a few more consultations to get other opinions.

A hump is not a hump

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Removal of a small nasal hump may or may not need infracturing (breaking) of the nasal bones. It depends on the width and thickness of your bones, and the size of the hump. Sometimes I tell my patients that I will not know for sure until I actually remove the bump. Breaking the bones does cause more swelling and bruising, but the result is usually worth it when it is required. Good luck!

Your nose needs breaking only if the 'Bump' change will be large.

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The need to 'break' the nasal bones with hump removal depends on how large teh hump is and how much of a change you want. I think it is best to work out the desired changes to the nose and the final appearance before surgery by computer simulation. That's the only way to answer your question.

G. Gregory Gallico III, MD
Boston Plastic Surgeon

Rhinoplasty and nasal bone infractures

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When a person undegoes rhinoplasty and has a small dorsal hump or bump, usually it is required to in-fracture the bones so that the top of the nose does not appear to flat and wide.  However, with small bumps, it may only require a little shaving down.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Rhinoplasty and Osteotomies...To Break or Not to Break, That is Your Question

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Hi Sim,

Whether to perform osteotomies (cutting the nasal bones) or not depends on many factors, including the width of your nose, and what else is being addressed. A small dorsal nasal hump can be removed without always having to "break the bones" (see web reference below).

What is most important is you communicating with your rhinoplasty what bothers you, and what final result you would be satisfied with. Then it is up to your surgeon to let you know if that can be achieved, and what it would entail.

Get a few opinions, but choose your surgeon most carefully, not necessarily based on whether your bones will be broken or not.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Rhinoplasty may need to break the nose in a precise way

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One of the most common questions in rhinoplasty is whether or not the nose will be broken to adjust the nasal shape. Patients tend to apply horrific images of this very common step, though most often the thin nasal bones are cut or perforated gently and molded into shape by pressure, and held by the nasal tapes and splint. Most often the break or cut is a 'green-stick' in nature and done in such a manner as to produce as little swelling or bruise as possible. As surgeons, we call these cuts osteotomies and there are several ways that they can be made depending on what is needed for the final nasal shape. The cut in the bone may be required in some patients quite independent of the hump present. Yes, after reducing a small hump it is not always necessary to 'break' the bone, however it may produce just the right shape to the bridge to make it all worthwhile.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 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.