Remove a nose bump - will the nose be wider from the front?

Question

I have a hump on my nose, but it looks small and pretty from the front. If I remove it, (like the top of a pyramid) won't it be wider? AND NO I honestly cant handle ostenemies or whatever they're called :(

Eugene Kim, MD · Answer

Thank you for your question. 
Yes, the nose will look slightly wider if the bump is removed.
Oftentimes, we do use osteotomies to broom the bones back so that it does not
look wider.  The fracturing of the bones
sometimes is necessary to close an open roof deformity which may cause an
inverted V.  That is why osteotomies are
often needed for the surgery.  I do my rhinoplasty
procedures under general anesthesia, so that is not a painful process to the
patient.  I hope this helps.

Alejandro Nogueira, MD · Answer

It is never good idea tell a surgeon what you can handle, you are willing to allow him to perform technically or grab his wrist when he is applying his expertise on you. And if you think this surgeon needs such advice you'd rather seek better hands and opinions for your intervention.

One very well known issue among surgeons who perform revision rhinoplasties, and I carry out many of them, is the so called "open roof deformity". Happens when, as simple as it sounds, the surgeons shaves the dorsum but performs no infractures / lateral osteotomies to close the bony pyramid.

So in short: there is no workaround, dorsal shaving requires necessarily lateral osteotomies, it is a must in the state of the arte more than 100 years ago; not doing so can be within a malpractice scnario and you'd get a flat, undefined and very ugly nose.

On top of that... open roof deformity is associated in 80% of cases with the so called "inverted V deformity", by dissociacion of the bony pyramid from the soft cartilagenous pyramid: the osseous one remains open (no infractures done) but the soft one closes effficiently and beyond the right point, leading to supratip collapse / pinching.

Beware of what you demand, someone could make it real.

ps: fyi, osteotomies are literally painless, this means exempt of any pain in the postoperative, there is no reason to fear them or be reluctant, but for a particular phobia; it is true they lead to massive bruison on eyelids and face, but this is how a rhinoplasty is before you and I were born.

ps bis: osteotomies can be wrongly performed, of course, if the skills are not good, very frequently they are incompetente, fragmental, random, too high, dramatically low, etc, but IMHO is one of the safest and most routinary gestures in rhinoplasty

Ronald J. Edelson, MD · Answer

You are right.  Simply removing the bump will make your nose appear wide and flat.  That is why the bones need to be broken and narrowed at the same time as the hump removal to create the ideal outcome.

Toby Mayer, MD · Answer

when your hump is removed osteotomies will be done to prevent the nose from being wide. I think your possible fear of osteotomies is unjustified as this does not increase any discomfort. The majority of my patients take no pain medicine or  One pain pill after rhinoplasty!

Roger Tsai, MD · Answer

Great question!  Short answer is yes it will make the nose wider. The dorsum of the nose is like the tip of a triangle - if you take off the hump, the tip of the "triangle" will be wider and flatter.  This is why osteotomies are performed in order to bring the base of the triangle closer causing the tip to be also narrow.  However with that said, if you only have very tiny hump, it could be removed without performing osteotomies and the results maybe okay - but you need to have an in-person consultation so that a good physical examination can be performed and options reviewed.  Best of luck and hope this information helps!- Dr. Roger Tsai

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. I suggest that you move forward and consult with your board certified facial plastic surgeon. A Rhinoplasty procedure can remove a nose bump and other irregularities on or around your nose. Please find comfort knowing that approximately 90% of individuals can see a positive change at one week following surgery. Best wishes,

William Portuese, MD · Answer

Yes, when removing nasal bump on the nose,  the nose will be  wider.  The dorsal hump is composed of both bone and cartilage which must be shaved down in order to remove it.  Once the hump has been removed, an open roof, flat-top nasal deformity is created.  Osteotomies are mandatory when the dorsal hump is removed.   The nose will look very strange after a hump removal  osteotomies.

Johnson C. Lee, MD · Answer

If you do not allow osteotomies to be performed, you will limit the amount of hump that can be removed safely without having a wide or "open roof" nose. A non-surgical option would be to blend the hump with filler to help smooth the lines of your nose. It is important to have an in-office examination to determine what the best treatment options are for your nose bump. Hope this helps!Johnson C. Lee, MD Plastic Surgery

Arian Mowlavi, MD, FACS (license on probation) · Answer

You are absolutely correct in that removing a nasal hump will result in the hump being eliminated; however, once the hump is removed, the nasal bones are fractured at the base(we call this an osteotomy) which allows your surgeon to bring in the nasal bones so that they meet in the middle;

Michael Elam, MD (retired) · Answer

Dear rosiecon12, When you reduce the dorsum with hump removal osteotomies are performed to bring the nasal bones back together and make the nose thinner as well as avoiding what is called an "open roof deformity." I perform many rhinoplasty procedures weekly and I routinely perform osteotomies. Patients are asleep during the procedure and patients have little to no discomfort from the osteotomies after their procedure. You can watch my video section of over fifty patients splint removals performed seven days post surgery for an example of the patients general post operative experience. Best regards, Michael V. Elam, M.D.

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