Can a Large Dorsal Hump Be Removed with Rasping Alone?

The nose is a pyramid. Removing a large hump is akin to chopping the top off the pyramid. If the sidewalls aren't closed then the top of the bones are splayed apart. That is called an open roof deformity. Some surgeons have euphamisms for not breaking the bones such as "micro-osteotomies" but that is really the same thing. "Breaking the bones" acually yields a better result and does not add any risk. You will have black and blue eyes for a few days longer but a better looking nose for the rest of your life.

Once a large dorsal hump has been removed it will create an open roof deformity since the left and right nasal bones will not be touching the septum.  This creates an open roof deformity, which is referred to a flat top effect.  To prevent this from occurring, both medial and lateral osteotomies must be performed.  The open roof deformity will not cause any physiologic problems, however it will be an undesirable effect cosmetically.

Dear Jerry,

 

Without photos and physical examination it is hard to give you a solid opinion about your case.

An osteotomy may be the way to go supplemented with in-fracturing of the bone.

It is important that a harmonious approach is to be adopted to keep your results as natural as possible fitting your facial features.


I encourage you to seek a consultation with a board certified surgeon of extensive experience in Rhinoplasty so you can make a well informed decision.

 

Best of luck to you and thank you for your question.

Dr. Sajjadian