Do I have a dorsal hump or saddle nose deformity? (photos)

Question

I'm wondering whether I have a regular hump or a saddle nose deformity. I am in need of a septorhinoplasty and nasal valve collapse correction for breathing issues.

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have thin nasal skin which is more prone to showing irregularities after rhinoplasty. You also have a crooked nasal base, and an overprojected nasal profile appearance. Goals of surgery may be a straighter nasal appearance that doesn’t stick out as far as it does.
If you need nasal valve repair, that would be best performed at your rhinoplasty. Hope this helps! Dr Joseph

Ozge Ergun, MD · Answer

A hump on the nose can be either a regular hump or a saddle nose deformity. A saddle nose deformity is a more complex condition that involves a collapse of the nasal bridge and a depression in the middle of the nose. It's important to consult with a board-certified plastic surgeon who has experience in septorhinoplasty and nasal valve correction.

Nima Shemirani, MD · Answer

Hi @KirstenR! Based on your photos, it appears that you have a dorsal hump. I recommend seeing an expert rhinoplasty specialist for in person examination. There are several options for you that can be determined after examination. A rhinoplasty in my opinion is one of the most difficult procedures to perform. I utilize piezosurgery in my practice. Piezosurgery is a more gentle technique that allows for greater precision. Less bruising and swelling is common with Piezosurgery. In a typical rhinoplasty, a hammer and chisel technique is performed leading to more inadvertent fractures. Best of luck to you, Dr. Nima!

Selcuk Inanli, MD · Answer

Hello Kirsten! Greetings from Istanbul.Thank you for your question. I have evaluated your case and from the photos it looks like you have saddle nose deformity but of course I can't say anything for sure before a complete consultation. I highly recommend you a Septorhinoplasty surgery. It will help first correcting your breathing issue and then aesthetically it will give a better shape.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. Your septorhinoplasty procedure to correct a nasal valve collapse can be combined with rhinoplasty to improve the appearance of your nose. The valve collapse may be the root cause of your nasal bridge indention and can be treated with this combination of procedures to create a smooth, feminine-looking result.

Please keep in mind that rhinoplasty is one of the most complex of all plastic surgery procedures, requiring experience, skill, and even artistry to achieve an optimal outcome. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon, with expertise in septoplasty and rhinoplasty techniques. They will be able to conduct a thorough examination and determine what steps are necessary to improve your breathing difficulties while also achieving your desired aesthetic.

Steven M. Denenberg, MD · Answer

Yes, you have a hump on the bridge. And there is indeed that dent between the bump and the tip. But your tip is very strong in its forward projection away from your face. If the tip were brought back closer to your face, that dent would no longer look saddle-y. In fact, ideally, your tip might be brought back closer to the face enough that some more might be carved off the area of the dent, in addition to lowering the bump. I hope I explained those mechanics well enough. The three-quarter view also shows the bump, but also the projection, and the width of the tip, and the top-to-bottom length of your nose.
How *much* to deproject the tip, or lower the bump, or narrow the tip, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

Oakley Smith, MD, FRCSC · Answer

Hello,
It seems that you have saddle nose, however this need to be confirmed wi†h physical examination. It is better for you to consult with a facial plastic surgeon who can examine you and discuss your treatment options.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. You are an excellent candidate for rhinoplasty.  In your case, you are a standard rhinoplasty.  You do not have a saddle nose deformity.  The functional aspects are fairly straightforward in rhinoplasty.  I think it is one of the most beautifying surgeries that we do as plastic surgeons. A large portion of my practice is dedicated to rhinoplasty surgery. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. The incision in open rhinoplasty heals almost always invisibly. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

Richard Clark, MD · Answer

You certainly don't have a saddle nose which is a collapse of most of the bridge. You have a classic bony/cartilaginous hump proceeded by a slight dip at the Nasion [beginning of the nasal bones at the eye level] and followed distally by a supra-tip break which dips a bit as the hump tapers off and the large over projected tip begins to dominate. Much more readily treatable of a problem...but find a skilled surgeon and avoid filler [ so called "nonsurgeical rhinoplasty" which would give you a larger more masculine nose ]. :-)

Joseph Shvidler, MD · Answer

Kirsten,
You have what we call a pseudo-hump or a saddle nose deformity, which is caused by saddling of the upper lateral cartilages. This may happen due to traumatic injury from a distant past and can also occur as a result of weakened cartilages. If you are unhappy about your tip in addition to the bridge, you will need a rhinoplasty. Nasal valve repair should also be performed at the time of rhinoplasty to strengthen the middle third of your nose with spreader grafts.

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