Will removing the dorsal hump make my face even longer? (Photos)

Question

Hi, I have a dorsal hump and want to remove it in a natural closed rhinoplasty. Will my new nose look too short for my face? Already I feel like there is a large gap between nose and lips. I will also add that I have an open bite, which jaw surgery has been recommended for, which makes my face longer

Semih Yildiz, MD, FEBOPRAS · Answer

Reducing a dorsal hump does not make the face anatomically longer, but changing the nasal profile can alter how facial proportions are perceived. In your photos, the nose appears relatively long with a dorsal convexity and downward tip, while the lower facial and jaw relationship also contributes strongly to the profile; the images cannot replace cephalometric and bite analysis. A conservative hump reduction without excessive tip shortening may make the nose look less prominent rather than making the face longer. The nose-to-lip distance and nasolabial angle are influenced by tip rotation, caudal septum, upper-lip length, and maxillary position, so those details matter more than the open versus closed approach. Because jaw surgery has been recommended for an open bite, coordinate the rhinoplasty plan with an oral and maxillofacial surgeon before proceeding. Orthognathic surgery can change the nasal base, upper-lip support, tip rotation, width, and overall profile. In many cases, jaw surgery is performed first and definitive rhinoplasty is delayed until healing and facial proportions stabilize, often 6–12 months, although selected procedures may be combined by an experienced team. Obtain a joint facial analysis and staged morphing so the nose is designed for the final jaw position, not the current one.

Oliver Chang, MD · Answer

Based off your photos - dorsal hump can be seen on front and side view, slight bulbous tip with small asymmetries. Due to the limited photos - different angles are not able to be seen to properly assess, but from your side profile - first addressing your dorsal hump and a slight pushdown of your dorsum will help fitting your nose more to the features of your face. Your upper lip, chin and forehead are almost in alignment which means reducing the dorsum of your nose can help with the 'long' ness of your face. 
A closed approach with dorsal hump reduction and dorsal push down preservation technique can be done as one of many options to address this. And possibly some minor tip work to reduce the bulbous tip. But not much needs to be done to preserve your natural nose to still keeping your facial profile as close to you as possible. Recommend doing this prior to considering any orthognathic procedure. Seek out a few different opinions prior to making a decision.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Kyle Kimura, MD · Answer

Thank you for your questions and photos. 
In short, reducing the dorsal hump can sometimes give an appearance of a longer nose, however, this should be evaluated in terms of your overall facial balance. In my opinion, the best way to determine if this would fit your face or not would be to perform virtual simulations of how this change would affect the rest of your face. I really like to do this with patients in real time to try and demonstrate exactly how these changes to the nose affect the rest of your face and whether these are things you like or not. Additionally it may be beneficial to see how addressing the hump changes the overall nose and whether you would also want to look into deprojection to decrease the appearance of a longer nose.
Ultimately, your best option is going to be to schedule a consult with a plastic surgeon that specializes in rhinoplasty to really go over all these changes with your nose and determine what fits you best.
Hope this helps and best of luck!Kyle Kimura, MD

Will removing the dorsal hump make my face even longer? (Photos)

Answers (4)

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