There might be occasionally a slight irregularity at the nasal dorsum after the hump removal. It can be overlooked at the time of surgery and show up after the swelling goes down, usually in a couple of months after surgery. It is usually due to bony irregularities, but in rare instances it can be due to cartilage.Several factors contribute to this: patient's anatomy and size of the hump, experience of the surgeon, diligence and attention to details of the surgeon. Sometimes speed is not the best thing in nasal surgery. Cartilage lumps or bumps usually do not form, but may be left behind if the surgeon is not meticulous and rushes through surgery. Nasal cartilage may also shift during healing, especially if they are not fixed with sutures.During hump removal, we take down the top of the septum and the cartilages attached to it. It is usually necessary to reattach the cartilages to the septum with sutures to prevent future collapse, deformity, breathing problems, and also formation of the irregularities. Frequently we have to place little grafts to further improve the shape and prevent these problems. Again, if the doctor does not take the time and care to do this part well, irregularities may show up in the future.
Just like scarring in the skin, bony scar or cartilage can regenerate and develop small lumps on the dorsum of the nose. More likely are irregularities that are present at the time of surgery that only become apparent after the swelling has resolved.
