How Often Do Doctors Get Hump Reduction Requests?

I recently had a rhinoplasty done about two months ago. The doctor did a fine job on everything I requested. My nagging concern relates to my hump.

Before the surgery, the hump wasn't a big issue for me, as I was more concerned with the tip and bone structure (I had previously broken my nose). As I mentioned, these were all taken care of perfectly, but the hump is now annoying me a bit. It is a bit more apparent now because the bridge is thinner and not hidden by all that cartilage. I decided not to completely remove the hump initially because I felt it would feminize my nose and remove some genetic characteristics. I'm not so sure now.

After the surgery, the doctor told me that I was one of the few who request a reduction of the hump, as opposed to a removal. Would this apply to you guys as well? I examined various before/after cases of hump rhinoplasties and many were described as hump reductions, rather than removals. The doctors would leave comments such as "moderate reduction of hump" or "conservative reduction". There were quite a few cases of these, so is my doctor just the exception? Thanks for your time and hope to hear from you guys!

Doctor Answers 8

Hump Reduction

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You are only 2 months into the healing process and after a Rhinoplasty with "hump reduction" there still may be swelling and scar tissue increasing the hump size. That being said, changing the nasal width and tip can make the hump look bigger. There is really no difference between hump reduction and removal - it's all a matter of proportions. This is why I believe morphing is such an important tool for communicating with patients. Obviously, your expectations related to your nasal hump were different than your surgeon's.

Newport Beach Plastic Surgeon
4.9 out of 5 stars 51 reviews

Hump reduction and removal are the same

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Hump reductions or removals are really the same thing. This is often accomplished by shaving it down with special files in the operating room. If you are unhappy and want the hump taken down, then discuss this with your doctor.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Hump Reduction or Removal...It's Semantics

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Hi Jay,

Prior to rhinoplasty it is most important to have very clear communication between patient and surgeon. It sounds like you and your surgeon were fairly clear about your desired goals. The "hump" is relative to the surrounding nasal structure and anatomy. As the nose is sculpted, the hump is gradually brought down. It is always better to err on the side of conservation of the "hump" as it is much easier to remove a little more than to have to add or augment the dorsum of the nose.

There is nothing to do about your hump at this point. You should be patient and stay close to your surgeon over the next 4 to 10 months. You may be very pleasantly surprised by the shape of your nose as it continues to heal during the first year after your surgery.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Need more time for the profile to develop

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It sounds like you are very early in the healing process and definitely need more time for your profile to improve. Computer imaging is an excellent tool in helping a patient and his sugeon decide what the ultimate profile should look like. The imaging is used as an educational tool. As a plastic surgeon we must make sure that the patient has realistic expectation of what can and cannot be done.

Hopefully, over time, your nasal dorsum will improve and you will be satisfied with the final result. Every one has different goals in rhinoplasty, making your desires known will aid in the pre-operative discussion concerning shape. It is always best to under promise a result. You never mentioned your age or sex but experience shows us that young single men can be difficult to please especially when it comes to rhinoplasty.

Personally, I use a drill with a bone cutting bur to get a precise contouring of the nasal dorsum. It is also important to know the level of the nasal radix. This is the most indented point of the nose as it joins the forehead. This should be at the level of the crease of the upper eyelids. If lower than this more caution need to be exercised when reducing the hump. Good luck and give it some time.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Computer imaging can help rhinoplasty surgery goals

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I am sorry to hear about your disappointment with rhinoplasty. I do sometimes have patients tell me when I reduce a nose that has been fractured that they do not want the bridge of the nose reduced. When contemplating rhinoplasty the amount of hump or dorsal reduction often is an important point to consider. The height will impact many other aspects as to how the nose will appear.

Men like to see a neutral or straight bridge and a strong masculine profile. I find that computer imaging or simulation can best help patients understand what the goal of the surgery is, and help the surgeon understand as well what the patient expects or would find best for them. An hour at the computer manipulating the nose can demonstrate what the new profile could look like. Computer imaging is only a simulation tool however it can be very helpful if a patient is confused or undecided as to what course to take. This is far better that attempting to quantify changes with words such as moderate.

All is not lost. Revision of your rhinoplasty is possible and straighforward with excellent results.

Best of luck.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Hump reduction requests are indeed rare

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Majority of my practice is primary and secondary rhinoplasties and it is rare, although not unheard of, for a patient to request to keep part of his or her hump. I agree that an over-reduced dorsum (bridge of the nose) is unattractive, but majority of my patients will not be happy if I left them a small hump. On the other hand, if you have a small hump and it is bothering you, the removal of it is not a complicated procedure.

Armen Vartany, MD
Los Angeles Plastic Surgeon

Depends on the patients desire.

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Hump reduction with regards to a rhinoplasty can be either a complete removal or a conservative removal. This relates to communication between the patient and the surgeon. The patient’s wishes, goals, and desires need to be addressed prior to the surgery so that there is no lack of communication. Some patients desire a strong profile while others desire only a small hint of a bump, and other patients, do not want the bump whatsoever.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

There is no right answer

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The over reduced nasal humps of many years past is not as popular a choice for nose. Many patients, particularly male patients, like to have natural elements in the nose to make it very difficult to determine whether a rhinoplasty was performed.

There is actually an art to hump reduction and the location of the placement of the hump. If the hump is placed too low on the nose, it can actually make the face look less attractive. Remember the goal in rhinoplasty is to make the face and nose more attractive.

I actually have patients who want hump reversals and desire replacement of their dorsal humps, which can be done and still make the face look more attractive. A well placed hump can actually photograph and film quite well.

I think computer imaging can be a valuable resource for communication. Ideally, details such as how your profile, tip, and shape of nose would be covered by your surgeon so that you feel confident in the proposed direction of your nose. Here you can preview changes to your nose and then determine ahead of time what you like and don't like. I give my patients a series of images so that they can think about this in great detail and then let me know what direction they would like to go.

It sounds like you like your overall look but are not sure about your hump. I would advise waiting before attempting to do anything about your nose. As is often the case, less is often more.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 181 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.