Can Cartilage Bumps or Lumps Form After Dorsal Hump Removal?

Cartilage bumps and lumps can form after rhinoplasty for different reasons:
1. When the skin and soft tissue swelling resolves over time, small bumps and lumps left over from the surgery can be revealed (like the rocks on the shore during low tide). Non-surgical rhinoplasty filler treatments can help small defects and irregularities. Surgery may be necessary larger problems.
2. During the healing process the soft tissue can contract and thicken especially above the nasal tip, to leave a supra-tip fullness. Compression strips and sometimes steroid injections will help improve this problem.
3. During the healing process the cut ends of bone and cartilage can form a healing scar tissue ridge or bone callus. A callus is an exudate and connective tissue from bone edges that forms during the healing process. In my experience the size of this scar tissue or callus varies from patient to patient. Compression strips can help with small ridges, larger lumps may need a second surgery.
4. Buckling of cartilage due to scar tissue contraction - especially in the tip. These “Bossae” form bumps in the nasal tip that usually require additional surgery to correct.
The best rhinoplasty surgeons understand these causes and attempts to prevent them or treat them appropriately once they form. If you develop these problems, I recommend seeking a Board Certified Rhinoplasty Surgeon comfortable performing revision rhinoplasty.

However, often as the swelling goes down after nasal surgery the patient may notice the normal tip cartilages which may be more prominent. The same is true over the prior hump. One may feel or see the bone more than before depending on what was done. You should discuss this with your surgeon.

Cartilage bumps can come after a hump removal. This is usually related to osteogenesis of both bone and cartilage from the removal site. It also occurs as the nose settles in and down, where bumps can become more apparent, especially in thin-skinned individuals.

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.