Non Surgical or Surgical Necessary? (photo)

I recently received a consultation from a dr (I live in in New York City). I was told I had poor tip support and would need a open rhinoplasty to place to support the tip and turn in upward. Also, remove the hump and break the bones on the sides of my bridge to make my nose look more narrow to achieve a "nicer looking nose". I honestly would not want my nose to look more narrow or smaller. I would just want my profile to be straightened and the bump at the top of the bridge gone somehow

Doctor Answers 14

Hump removal from nose requires surgical rhinoplasty

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The only way to remove the hump on the bridge of the nose is through surgical rhinoplasty.  Once a large hump has been filed down, the nose bones must be narrowed to prevent an open roof or flat-topped nose deformity.  This is performed through osteotomies and there is a mild narrowing effect that occurs when the nasal bones are reset inwards.  A small amount of tip surgery is sometimes required to make sure that the tip is balanced with the remainder of the nose.

You appear to be a better candidate for Rhinoplasty Surgery than a Non-Surgical Rhinoplasty.

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I agree with the surgeon you consulted: Your tip is underprojected and needs support. In that regard, you may consider consulting several experienced rhinoplasty specialists to see what might be best for you.

Your bump is not at the top of your bridge: rather it appears to be in your mid-bridge. And since your bump projects further than your tip, injectable fillers above your bump may not be the best option for you.

Hope this helps you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 429 reviews

Rhinoplasty #nosejob

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Rhinoplasty surgery is very delicate and is difficult at best. First you should choose a surgeon who is board certified and has the goals in mind that you are trying to obtain. There are so many maneuvers that can be performed to reshape the nose. Careful analysis internally and externally is so important as is a clear understanding of your goals. The reason the surgeon spoke of making small fractures into the bone to narrow them is because when you take the top bump down the nose looks very square. We call that an "open roof deformity." Imagine cutting the the triangular shaped roof off of the top of a house. It would then look square. The same thing happens to the nose. In order to close the open roof created by taking down the bump on the nose, one must fracture the nasal bones and move them inward slightly to re-creat that natural shape to the top of the nose. It would be like putting the roof back on a house so that there is not a square look to the house. Make sense?? As for the other things you want just be very clear with your surgeon and make sure they are darn good at noses. I love Rhinoplasty surgery. It is my favorite operation. You want someone who feels the same because that is the person who will be passionate about your result. 


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Although a formal consultation is recommended, a surgical rhinoplasty appears to be necessary to achieve the results you seek based on the photos you have provided.  Non-surgical rhinoplasty is best for patients with a small hump to enhance the profile.  Please consult with a board certified specialist who can best assist you in achieving the results you seek.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

No need for open

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I would do a closed rhinoplasty, obviously, an in person consultation is needed for a full evaluation, but I see no reason a well done closed rhinoplasty would not succeed in giving you a good result without an outside scar.


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Your posted photos are inadequate for a full assessment because the eyes are not visible on the side view, the chin is not visible in any view, the head is tilted on the front view and the downward oblique view is non-contributory. It looks like your bridge is shifted to the left and your radix lies at or below pupil level. If you turn the tip upward more you risk being able to look into both nostrils on front view. The current tip rotation looks fine. I am not so sure you need hump removal and suspect augmentation of the bridge that moves the radix up to pupil level is a better option. If that is the case infracture (breaking the bones) may not be necessary unless that will move the bridge into the midline. Unless a finger tip pushing on the nasal tip goes all the way back there is nothing wrong with the current tip support structures.

Even if augmenting the bridge alone would give you most of what you want I am not sure an injectable filler (non-surgical rhinoplasty) is the best or most reliable way to do that.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

To reduce a bump, surgical rhinoplasty is usually better

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There are a number of ways to reduce or camouflage a nasal hump. Non surgical rhinoplasty fills in above the bump to make the profile more even. However your tip may also be a little weak and need strengthening as well. I like computer imaging to show what works best. Sometimes its a little hump removal and a little addition above and below to get the ideal balance for your face. 

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 134 reviews

Hump removal in rhinoplasty.

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It makes no difference as to open or closed for what you want. Seek out a rhinoplasty surgeon that understands what YOU want and not what he wants.  You will be seeing your nose every day not him.  You are the one who needs to like your new nose!

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Simple Nasal Hump Removal

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You only need a conservative nasal dorsal hump reduction. You have to remember that all surgeons have their own preferences and methods. It is not right or wrong, just a personal approach or philosophy.

You need to communicate your EXACT desires to the surgeon and that will help her/him to understand your needs better.

One more important point; when the hump is reduced it does involve breaking nasal bones, there is no way around it.


Dr. J


Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

Open rhinoplasty best for non-projecting tip.

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You will do best with surgery.  The bump in your profile is not the only thing that can be improved.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.