Can I Get Only Nose Rasping Done Instead of Full Rhinoplasty? (photo)

I agree with the other surgeons weighing in on your concerns.  It is never just as easy as taking down a small hump because of the the other changes that will occur. As mentioned your nose changes vertical height with hump resection and will change from the classic and aesthetically pleasing pyramid shape to one that is trapezoidal in nature if ostetomies (nose-breaking) are not performed.  An in-person consultation with a rhinoplasty specialist will help you decide what is the best course of treatment.  Good luck to you.

Depending on the individual circumstances of the patient, osteotomies (fracturing of the nasal bones) can be necessary. Fracturing the nasal bones, or performing "osteotomies" is a technique we use for narrowing the nasal bones and/or closing an "open roof deformity." In general, when we take off a nasal hump, the bone can have a gap. Nasal bones are fractured to close the open roof that can occur after you take the hump down, and close the "ledge." We need to fracture the nasal bones in, performing lateral and medial osteotomies. Performing osteotomies narrows the upper middle part of the nose. The medial osteotomies finish narrowing the bone. I would recommend a consult with a board certified rhinoplasty specialist. They will be able to examine your nose in person and provide you with advice. Cost can vary depending on the surgeon, the complexity of the surgery, and your location. I hope this helps, and I wish you the best of luck.

Looking at the photos provided, you will probably require osteotomies (breaking the nasal bones) in conjunction with reduction of your bridge. If you don't break the bones after rasping the bump down, your nose will likely look too wide as seen from the frontal view. 

The first and most obvious goal any patient seeking rhinoplasty should have is satisfaction with the appearance of the nose after the procedure.  I would not agree to rasp your dorsal hump in isolation, because the chance of satisfaction with this approach is zero.  I recommend following the advice of Dr. Dennenberg, because each action a Surgeon takes in Rhinoplasty produces a reactive change.  Rasping or chiseling down a nasal hump leads to a broad, flat appearance known as a "book-spine deformity".  Osteotomies, or breaking the nasal bones allows the Surgeon to narrow the nasal bones, and restore harmony to the appearance of the nose.

There are a couple reasons not to just shave off the bump. First, if you just shave off the bump, it would leave a flat spot on your nose where the bump was. If the bump is like an Egyptian pyramid, and you take the top off, you are left with a flat plateau. Narrowing the bones makes the bridge of your nose normally narrow again after removing the hump. See my "Web reference" link for a morph of your nose without the hump, and more explanation of this topic.

There's another, less obvious reason not to just shave it off. When a hump is taken from a nose, it can make the nose *look* longer, as though the tip drooped down, even if the position of the tip didn't really change. The amount of that effect is different on different people, but the larger the hump, the more likely that we would consider raising the tip a little, not to make a shorty nose, or to change the character of your nose, but just so that the nose doesn't look longer to you after surgery. I made some morphs of that, too. 

Finally, in an operation that takes me about three hours, narrowing the nasal bones takes about three minutes, and it doesn't noticeably increase the swelling or bruising, so it's really a small issue.

Your nasal hump is made of both cartilage and bone.  The bone can certainly be rasped but the cartilage can not be rasped.  The cartilage needs to be removed either with a scissors or a knife.  This then leaves a flatness to the nasal dorsum which is closed by performing a fracture of the nasal bones. 

Many rhinoplasty patients make this type of request feeling that this is the only area that concerns them. Rhinoplasty surgery is about creating balance and often one step creates change elsewhere which needs to be addressed to keep the balance. Although I can't say for sure from these photos it's likely that if you only lower the hump you will have a flat wide bridge and your tip will now appear larger to you as well. Rhinoplasty surgeons also like to think that we use osteotomes to make precise bone cuts and that "breaking " them only occurs in accidents and fights. An in person consult with some computer imaging may help you better picture what you are looking for. Good luck.

  Rasping the bridge is only good for very small bumps.  When a large hump is removed it will leave a  flat top nose, otherwise known as a open roof deformity. This will not look appropriate, therefore medial and lateral osteotomies will need to be performed to narrow the sidewalls.

Yes, you have a small bump that is probably both bone and cartilage, but you will need the bones carefully infractures to not leave you with a flat wide nose and to recreate nice dorsal lines.

Rasping alone will provide a pleasing appearance from the side view, but as the bridge is progressively reduced the front view of the nose will gradually demonstrate a widening, with the two nasal bones forming distinct lines on each side of the bridge. This could be camouflaged with an onlay graft of bone or cartilage but the base of the the nose where the bone meets the facial bones may still look too wide. I understand your concern about the 'breaking' of the nose but if you are seen by an accomplished nasal surgeon and he/she recommends the nasal bones be infractured, then you would be best served by having that portion of the surgery performed. The 1-2 weeks of possible increased bruising would be worth the long term improvement in results.  Best of Luck  Dr Harrell