Can a dorsal hump be shaved down and leave same say with no splint? (photos)

The plastic surgeon I saw said he could easily shave my dorsal hump down and I would leave the office that day with no splint just a bandage over the nose. Is this even possible? I do not want any other work on my nose not even the tip. Just want the hump removed

Doctor Answers 9

Full Rhinoplasty Needed

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Dear Marisao,

In some unusual circumstances a very tiny bump could be shaved down, but yours is significant in size. You would need to have the lateral nasal bones fractured inwards to restore the triangular shape of the nasal dorsum. Otherwise, the hump will be gone, but you will be left with a nose that looks very broad and flat. Even if you want no change other than the hump taken down you are going to require a splint and full rhinoplasty.

I hope this has been helpful to you.

Robert D. Wilcox, MD

Dallas Plastic Surgeon
4.1 out of 5 stars 22 reviews

Rhinoplasty for dorsal hump removal

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Unfortunately, you were given bad advice. The dorsal hump is a surgical procedure performed in an outpatient surgery Center, not in an office setting. The dorsal hump is composed of both bone and cartilage and must be shaved down in order to remove it. An open roof, flat top deformity will be created from the hump removal.  The frontal profile will look terrible without osteotomies.  Remember, the nose is a three-dimensional structure and must look good in all dimensions. Osteotomies are performed on the nasal bones to narrow  them and close the open roof deformity created from the hump removal. A cast is then applied across the nose and left in place for one week. Anticipate 2 weeks of bruising and swelling. A rhinoplasty with hump removal and osteotomies  is a surgical procedure performed under general anesthesia as an outpatient surgical procedure.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 155 reviews

Can a dorsal hump be shaved down and leave same say with no splint?

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Sure, it is possible. Is it advisable? Maybe not. Once the dorsal hump is shaved down, the base of the nose may appear too wide for your face. If this is the case, you will need osteotomies to correct it. Osteotomies will require a splint. Without a physical exam, it is impossible to determine if this would be the case for you. Please consult a Board Certified Plastic surgeon in good standing. I hope this helps.
Best wishes,
Gary Horndeski M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.5 out of 5 stars 229 reviews

Can a dorsal hump be shaved down and leave same say with no splint?

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It is possible. However, based on limited photos, but without an examination,  most excellent plastic surgeons with extensive experience performing nasal cosmetic surgery would caution against it.

Following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on limited 2 dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the operative procedure would not be in your best interest. I would suggest you find a plastic surgeon with extensive nasal surgery experience who is certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or facial plastic surgeon (ENT) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Additional information about the procedure will help you decide if it is a procedure that you want to pursue.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

Shaving Dorsal Nasal Hump

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I hate to be the bearer of bad news,  but based in these pictures without the opportunity to examine you, I would disagree if you want the entire hump removed. It would be necessary to break the bones (osteotomies) and reposition them to avoid a wide nose after surgery. A splint would be necessary unless you just remove a portion of your hump.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 42 reviews

Hump removal

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In some circumstances, a very small dorsal hump could just be shaved down under local anesthesia.  As long as a separation is not created between the nasal bones and the septum, an "open roof deformity", there would be no need for a splint. 

Your pictures indicate that you have a significant dorsal hump.  The above scenario would not apply to you, and invariably, to have an acceptable outcome, you would at least need lateral osteotomies to close the open roof deformity.  Splints are used after osteotomies to help your nasal bones heal in a configuration that is desired. Ultimately, you could choose not to splint the nose after osteotomies, and while this is not equivocal to casting a broken arm after setting the bone, many rhinoplasty surgeons consider it very important after surgery.  If you are choosing to proceed with rhinoplasty I would suggest you do everything in your power to achieve the best outcome, and splinting after osteotomies is considered the standard of care.

Patrick Simon, MD
Rockford Facial Plastic Surgeon

Removing a dorsal hump in the office

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Advice is limited based on the limitations of the photos and the on-line format. It is my opinion and experience that to obtain a balanced result, most patients need some other adjustment to their nose in addition to removing a dorsal hump (commonly, if this is done in isolation, the nose appears too long after surgery). Assuming you are a candidate for a 'hump-only' procedure, and assuming the surgeon has a certified operative suite in his office (check for "AAAASF Certification"), this approach seems fine. Regarding a splint, this is largely surgeon dependent so it is not 'wrong' to not use one. 

I hope this helps - good luck!

Bryan Correa, MD
Houston Plastic Surgeon

Ambulatory surgery is desirable

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Most rhinoplasty surgeries are performed in the operating room with a qualified anesthetist to deliver sedation or general anesthesia.  A well equipped and appropriately staffed office with surgical facilities could fit the bill.  Many surgeons running private surgical facilities in their office seek to fulfill safety standards set by a recognized independent accrediting body. In the US, the following are recognized national organizations involved in accreditation of surgical facilities: Accreditation Association for Ambulatory Health Care (AAAHC), The Joint Commission (TJC), American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF), and Medicare.  It might be prudent to research further the office facility and the qualifications of the health professional delivering the anesthesia.

The application of a dorsal nasal splint is highly variable with each plastic surgeon's custom of practice. Significant hump reduction as shown in your photos often necessitates lateral osteotomy to infracture the  nasal bone to avoid an open roof deformity. In my practice, I use a dorsal nasal splint to protect the bone position. Not using a splint is less common but not inappropriate.

Chen Lee, MD
Montreal Plastic Surgeon
5.0 out of 5 stars 20 reviews

Dorsal hump removal

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Thank you for your question.  While it is certainly possible to remove the dorsal hump without doing much else, I would caution you that unless he is also going to perform osteotomies, you will likely be left with an open roof deformity.  This will make your nose look wide and possibly show the edges where the bump was removed from.  Your second question about the splint is probably a less important one as long as the nose is taped well.  The splint helps with swelling and to make the nose initially conform to the shape desired, but a really good tape job will probably be adequate as far as the swelling.  I prefer to use tape and splints, but don't think the idea of not using a splint is crazy.  

Sirius K. Yoo, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 28 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.