Is it possible to get your dorsal hump shaved without breaking the nose if the bump is very slight? (Photos)

If the dorsal bump is very small, it can be shaved without performing osteotomies. This is usually determined during surgery. If shaving the bump down creates an open roof, then the bones will need to be brought in. Doing this will not affect the tip, you may consider doing some tipwork at the same time if the droop bothers you.

Hi @kaylarene4! It is not ideal to shave down a dorsal hump without performing osteotomies because when the dorsal hump is shaved down, the bridge across the left and right nasal bones will be removed. This leads you with a wide flat bridge and visible left nasal bone and a separate visible right nasal bone also known as an open roof deformity. If you shave just the dorsal hump, the nose will appear even longer on profile. A rhinoplasty in my opinion is one of the most difficult procedures to perform. In my practice, I utilize piezosurgery. 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, Dr. Nima!

Smaller dorsal hump reductions may not require nasal bone osteotomies (breaking of the nasal bones); you may very well fit into this category. The ideal dorsum would have smooth dorsonasal lines, without visible bumps from any angle. Unfortunately, I don't think it would cost significantly less if osteotomies are not performed. If you are going to have a rhinoplasty, tip work could help adjust the rotation and improve the appearance of a droopy tip. 

It is uncommon to perform a rhinoplasty removing the bump and not breaking the nose.  If the surgeon tries there will most likely be a suboptimal result. I tell patients that the breaking of the bones is quite routine and worth the extra bruising that may occur fir a week or two.

Yes, theoretically, if the bump is slight, then you can shave it down and do nothing else. But here are some of the thousand problems you can get into:The frontal view shows that your bones sit in somewhat of a wide position, so we would want to narrow the bones. Shaving the bump would make the nose look wider yet, and make it more important to narrow the bones. But you can't just "shave" them from the sides. The bones are only 1mm thick, so to narrow them you have to move them, not shave them. Shaving them doesn't work.Then, lowering the bump actually tends to make the nose *look* longer, as if the tip had drooped, and that second photo makes it look as though elevating your tip a bit would look nice. Just working on the bump would make your nose look longer, not shorter.Then, lessening the prominence of the bump would also tend to make the tip look wider where it sits next to the now-less-prominent bump.See? You really should have a real rhinoplasty, or leave it alone. I can also tell you that narrowing the bones, "breaking" the nose, is a nothing. In expert hands, it doesn't increase the bruising or bleeding or swelling or recovery time, and in an operation that takes (me) about four hours, that part of the operation is just a minute or two, so it's not something to fear.
How *much* to elevate the tip, or lower the bump, or make other changes to the nose? 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 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 always 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 only the surgeon has that information and judgment. Another aside: I also recommend that you not show morphs made by one surgeon to a different surgeon. If a surgeon makes his *own* morphs, you get to see whether he understands the important issues of your nose, and how your nose should be changed. But if you show the surgeon someone else's morphs, and he says "Of course I can make your nose look like that," then you don't really know if he fully understands, or even recognizes, the important changes shown in those morphs. And you don't know if he can make those changes during surgery.)
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.
Your nose is also a perfect example of why computer imaging by the operating surgeon is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?

It is possible to shave down the hump a little without having to break down all the bones. However it can sometimes leave the dorsum looking a little wide. It will not effect the tip appearance in any significant way.RegardsDr. J

Thank you for you question and photos. A minimal change could be possible without osteotomies ("breaking" the nasal bones), but I don't think you would be happy with the result.  You should consider a standard rhinoplasty to adjust the different components of your nose to work together for a look that you will be happy with.  That would likely include osteotomies and adjustment of the tip shape and position.  Consult with at least two Board Certified Plastic Surgeons with rhinoplasty experience before deciding. 

Dear kaylarene4,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from a rhinoplasty. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your questions and for sharing your photographs.
The short answer is yes, slight bumps can be shaved without fracturing bone (osteotomies). However, too much shaving can result in open roof deformity. In general perforimng osteotomies do not result in any significant pain or morbidity and therefore your focus must be in getting the best result. Neither method affect the shape of your nasal tip. Correction of a droopy nose (nasal tip ptosis) is commonly performed when indicated.
You
are a good candidate for Rhinoplasty.  I would suggest that you consult an expert rhinoplasty surgeon. A
full detailed examination of your nose is required to assess your nasal skin,
cartilage and bony structures. This will allow the surgeon to evaluate your
nasal appearance and it’s relation to your facial features as well as your
nasal airway and breathing.
The use of manipulated (morphed) digital clinical photography
provides a platform for discussion as to your desires and expectations. Such
images are not a guarantee of exact results, but a great tool to ensure that
you and your surgeon are on the same wavelength.
It is paramount that you have a realistic expectation before
proceeding with this surgery. You must also trust your surgeon and feel
comfortable and confident with your treatment plan.
Best wishes

 A full rhinoplasty is going to be required  to not only shave down the dorsal hump, but  augment the concave upper lateral cartilages in the concave midportion of the nose with spreader grafts.  A cephalic trim of the lower lateral cartilages in the nasal tip can refine that area as well.  The tip can be lifted statically to  improve the drooping tip that is present.  Also important to release the depressor septi ligament  which pulls the tip down dynamically when smiling.  Osteotomies are going to be required in the nasal bones to close the open roof deformity created from the hump removal itself.  A closed rhinoplasty approach can accomplish your goals by placement of all incisions on the inside of the nose.  Digital computer imaging would be helpful to understand what can and cannot be accomplished with your nose upon your facial features.  Fortunately, you get to keep your freckles!