Can I Elevate my Tip to Disguise my Hump Without Dorsal Rasping?

I think the better way to improve your profile is to build up the bridge of your nose in the area called the radix.  This is the portion of your bridge above your hump.  This will give you a more feminine profile, while making your nose and face appear slightly more narrow.  Removing the hump will make your nose appear wider.  Rotating the tip will not have a significant effect on the appearance of the hump. 

In my opinion, you do need something to stabilize the tip.  This usually is done with a columellar strut, but can be accomplished with other techniques as well (ie the septal tongue-in-groove maneuver).  You are right that by first projecting your tip, the amount of reduction of your bridge will be less.  You have basically a "pseudohump" caused by a low radix (the starting point of the nose) and an underprojected tip.  The key to having a long-lasting and pleasing result for your nose is stable tip projection.

The approach to rhinoplasty is very individualized.  In general, I agree with Dr. Lee that your tip should be augmented with cartilage tip graft in addition to slight elevation of the tip.  Upward tip rotation, in my hands, is predictably accomplished by trimming lower lateral cartilages, caudal septum, tip graft, and potentially, suturing to septum.  Lowering the dorsum and/or augmenting the radix (top of the nose) won't really add much down time, although it may add some cost, but will improve your overall result considerably.  Treating the tip alone will NOT camouflage the dorsal bump.  

You are young and beautiful.  If the nose bothers you, and the dorsal hump bothers you at all, I would treat the dorsum as well.  It will be worth it many times over in the long run, provided your result is good.

The nose can be improved by giving more tip projection. However, you'll need more than suturing in order to accomplish this. The cartilages at the tip are very soft and will need reinforcement with additional cartilage in order to get the tip projection and strength you need. Also, you can place a graft, usually temporalis fascia, in the area between your eyes (radix) in order to make the bridge more straight without rasping the hump. 

 

you absolutely can do this. I have a number of patients who have this procedure done where I placed a cartilage graft on their columella or under their tip to support the tip and hold it up. I get patients from China and other parts of Asia frequently for issues very similar to yours. Often times in China surgeons will recommend you use an implant but you should not do this. This appears to be medium thickness skin with a simple issue of what we call top ptosis. You need to elevation which is a surgery that requires a highly skilled and experienced surgeon but in general is not a very large surgery and you should heal within one to two weeks. Do not use an implant. As you raise the tip the hump on your nose will be less apparent. I can tell it was not always this way. I can tell that you are in your 30s or older and that your tip when you're younger was not as low as it is now and the hump on your nose was not as obvious as it is now.

Chase Lay, MD

double board certified facial plastic surgeon

Asian facial plastics specialist