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A very small hump can be rasped off in order to remove the bony hump. When the hump is composed of cartilage, this must be cut with a knife or scissors. When a large hump is removed, osteotomies of the nasal bones are required. For many examples, please see link below
Rhinoplasty is an excellent and really only way to permanently reduce a dorsal hump. This is often preformed with rasping the bone and cartilage combined with osteotomies. Best of luck.
I think you have reasonable goals and the rasping down of the dorsum should be done in a controlled fashion, which means that the prominent areas will be taken down in gradual amounts until the preferred shape is seen. You also have a hanging columella, which I would advise you to improve as well. While any type of nose revision you undergo will have risks of making your nose look worse, there is no way to make it better without doing a revision. I would advise you to be evaluated by a board certified plastic surgeon, who has experience in rhinoplasty and revision rhinoplasty and will give you a comprehensive assessment of your nose and options to improve it.
Depending on your insurance company, they will generally cover some or all of any functional portion of the surgery. Anything cosmetic is not covered. I would recommend speaking with your prospective surgeon, as he/she will be able to best advise you. I hope this information helps, and I wish...
Although you have had two previous surgeries, your skin quality looks good, and there is no reason you could not undergo additional surgery. Your nasal tip is over projecting ( sticks out a long ways from your face), and it looks as although your upper dorsum was lowered but not the nasal tip,...
It's possible that some of these asymmetries and the supratip area can be fixed in-office with just fillers and may not require surgery at all. I tend to use Juvederm to start with since it's temporary. Then, if the patient and I like the results, it can be fixed essentially permanently with...