Hump After Nose Job

I would agree that the first issue to consider is sof t tissue swelling, since it sounds like the profile was appropriate right after the splint was removed.  That would take care of itself with time.  However I agree with one of the other surgeons who note that humps can regrow.  We have all seen the scenario.  My explanation would also include that the periosteum becomes active and thickened after trauma (which is one reason why broken noses have that hump on top).  Left unchecked, that periosteum can either remain thickened, calcify, or lay down additional bone.  in the end, we see fullness of the bridge that was not present before trauma or surgery.

You can remedy this with a simple office injection of kenalog.  In fact, the surgeon can feel the needle pop through this rind of inflammation and enter the space that is expanded, almost like the shell of an egg.  No additional surgery.  But it should be done soon, before the body matures in this full state.

The periosteum and muscle over the nasal bone swell after Rhinoplasty. This takes months to resolve and the skin feels spongy over the bridge. We recommend massage 2-3x/ day and occasionally re- taping for a month. The scar fade gels will help. Give it time! Dr. G.

A hump that recurs after rhinoplasty is most likely due to the formation of fibrous tissue at the area of a bony injury. This can be easily seen in anyone who has broken a collar bone and has a big lump where the bone is healing. I agree that an injection of steroid is appropriate in this circumstance to help the fullness disappear as quickly as possible. Nightly taping can also help. Ultimately, discuss this with your surgeon.

Andrew C. Campbell, M.D.

Board Certified Facial Plastic Surgeon

This is probably just swelling and goes away. If your surgeon is not concerned don't worry about it since he knows what he did.

I read your concern. It's possible the bump is swelling, but more likely, you're seeing a bump as your soft-tissue swelling is resolving. In general, your profile should look nice when your dressing is removed. The front view tends to look more swollen.

If the bump is just swelling, it should feel soft, and disappear with gentle digital compression.

Many bumps on the bridge of your nose may be improved after Rhinoplasty Surgery with a well-performed Injectable Filler procedure. My preference is to use Silikon-1000, an off label filler, for permanent results.

Feel free to email your photos, and I'll be happy to share my thoughts with you.

I hope this is helpful for you.

A hump can grow after rhinoplasty - we call this a callus, scar tissue or swelling.  Hump reduction usually requires sharp removal or rasping of the nasal bones.  The bone edges initially bleeds, forms a matrix that incorporates fibroblasts and blood vessels - ultimately forming a callus or scar tissue.  This callus with undergo a process of remodeling over a period of 12 to 18 months - usually reducing in size.  

The swelling and callus formation will vary from case to case and some surgeons recommend taping to control swelling and callus formation.  In any case, it is best to wait 12 months.

If you had a hump prior to surgery, and you have a hump now, it is possible that the hump was not fully removed and was camoflauged with swelling.  Another possibility is that you still have swelling, and that is giving the apprearance of a hump.  If the appearance of the hump is not improved after 6 months, you may need a revision surgery.  I doubt that any cream is going to make any difference.

Hi Muff,

It takes up to 12 months after rhinoplasty for your nose to settle.  I am unaware of any "cream" or ointment that helps with decreasing a dorsal hump in the early weeks after rhinoplasty.  What is the cream that you are using.  If your nose still bothers you after one year, then consider revision, until then patience is best.  Good luck and be well.

Dr. P

Unless there was unsual bony ingrowth, humps do not regrow.  It may very well be swelling of the soft tissue and you should give it time to heal. If this hump is still present at one year, you may need a small revision.

It is possible that you have some swelling in the area of surgery that needs time to get better.  For this reason, I sometimes tape the nose after I remove the splint to help minimize this occurrence.  I would suggest you not worry unless it seem to stay exactly the same for the next 3 to 6 months.  If so, often a minor revision should take care of it.