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

I like my nose, it's small & cute but the only problem I have is that from the side I have the biggest bump that is so noticeable. It makes me very insecure and I can't even take pictures of myself except from the front because the bump is that noticeable. I wanted to know if a surgeon can just shave it down instead of breaking my nose? & how much would it cost?

Doctor Answers 14

Almost certainly need to narrow the bones, but that's not a bad thing!

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.

Omaha Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Nasal dorsal bump

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.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Can I only get nose rasping done instead of a full rhinoplasty?

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.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 44 reviews

Narrowing of Nose Probably Needed

You're correct in that you have a beautiful nose that would be improved by removing the dorsal hump.  In a sense, it's not a full rhinoplasty...the extra bone and cartilage is simply shaved down and then a "green-stick" fracture of the nasal bones is be performed to narrow the nasal dorsum but not the base of the bones.  This will give you an excellent result from both the lateral and frontal views with minimal risk and downtime.

Eric Sadeh, MD
Manhattan Plastic Surgeon
4.4 out of 5 stars 55 reviews

Rasping or full rhinoplasty

If you only rasp the hump down your nasal bridge width will appear to wide form the frontal view.  This is the reason that the nose needs to be broken after hump removal to narrow the bridge.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 42 reviews

Nothing is as simple as it seems in rhinoplasty

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.

Giancarlo Zuliani, MD
Rochester Facial Plastic Surgeon
5.0 out of 5 stars 50 reviews

Nose Rasping Will Probably Need Osteotomies

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. 

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

More complicated then just rasping the bone to smooth down the dorsal hump

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. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

Rasping Alone a Bad Idea

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.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 81 reviews

Can I only get rasping done?

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.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.7 out of 5 stars 9 reviews

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.