Osteotomy After Hump Removal?

I have a fairly small to moderate sized dorsal hump (depending on lighting) and after several consults, each surgeon has said that they would need to perform an osteotomy. Thats fine, but I DONT want my nose to change much from the front, if at all. How do I deal with this dilemma?

Doctor Answers 18


You have a greater risk of your nose looking different from the front if you DO NOT have osteotomies.  Without the osteotomies, your nose will appear wide and flat.  It sounds like you definitely need the bones broken.  Don't be afraid of having the bones broken.  It is done in a very controlled manner and does not usually hurt too much.

San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Osteotomies preserve nasal width

The use of cuts into the bones around the nose (osteotomies), is very important in preserving the nasal width.  Removal of a hump and no osteotomies may leave the nose looking wider than pre surgery.  Osteotomies can reshape the nose and improve the balance.

Robert Mounsey, MD
Toronto Facial Plastic Surgeon
4.7 out of 5 stars 11 reviews

Does removing a bump on ones nose always require an osteotomy?

I have removed nasal bumps that are very subtle without performing an osteotomy. To determine if you require one I would at least need to see a photo of your profile. However, whether or not an osteotomy is performed your straight on appearance will be slightly altered anyway. Once the bump is removed the bridge always is different from the original with or without the osteotomy. If an osteotomy is needed but not performed this will result in an unnaturally flat bridge that differs markedly from your present one

David A. Ross, MD (retired)
Chicago Plastic Surgeon
4.6 out of 5 stars 89 reviews

Osteotomy and dorsal hump

The majority of dorsal hump removals require an osteotomy to elilminate the open roof or flatness that you would have from just reducing the hump.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Hump takedown and Osteotomies

In the vast majority of cases, when a dorsal hump is taken down, we are left what is called an open roof deformity. Meaning, the septum and the upper lateral cartilages do not merge at the midline, giving you a flat as opposed to a round bridge. In order to "fix" that problem, we need to bring in the nasal bones close to each other. This is done with a carefully done cut on the bone or osteotomies.  In cases where the hum is very small and or mostly made of cartilage, an osteotomy can be avoided.

Marcelo Ghersi, MD
Miami Plastic Surgeon
5.0 out of 5 stars 150 reviews

Is an Osteotomy Needed with Rhinoplasty

Some rhinoplasty patients need an osteotomy after surgery and some do not.Without any photos it is not possible to comment in detail about your case.There are multiple ways to perform the osteotomy which may alter your final result.The most important requirement is that the surgeon is experienced in the surgery.I have found computer imaging is also helpful to aid in the visualization of the potential result.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews

Grasping the hump and lifting the point avoids humping removing if this is small and avoid fracture

if your nose is  straight and minimum hump you could avoid, nose bone fracture just grasping the hump and lifting the point it is called  a"partial rhynoplasty"

that means less agressive. the cause of any  nasal bone fracture are for 3 reasons only

1.- big hump remotion

2.-wide nose bones

3.- deviated nose

Ramon Navarro, MD
Mexico Plastic Surgeon
5.0 out of 5 stars 2 reviews

Osteotomy After Hump Removal? #nosejob

You present a tough question. If you want the bump taken down then you will certainly have the front of your nose look different. It is impossible to take that bump down and not have it affect your profile and front view. When the bump is taken down and you do not have nasal bone osteotomies then you can be left with an open roof deformity.  An open roof deformity occurs when a bump is taken down several millimeters and then no osteotomy is performed. The bump on any given nose usually has a cartilage and a bone component to it and both are generally reduced. You need to feel comfortable that your surgeon will make the changes only that you want, but you also have to realize you are changing your nose. There is no way around it. How subtle that change is depends on what you and your surgeon discussed. Trust is everything. If you do not trust your surgeon, and have not seen their work then second, third, and forth opinions are in order until you find the one. 

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 49 reviews

Osteotomy after hump reduciton

Nasal surgery requires a keen eye and a steady hand.  You need to find a board certified plastic surgeon with lots of experience to maximize you chances for a successful outcome.  Be sure to see a comprehensive portfolio of pre- and post-op pictures  so you can gauge the types of results that are reasonable to expect.


Osteotomies are often required after hump removal so that the new dorsum doesn't have a flat surface that makes the nose look to wide.  If your surgeon can't explain this to you in a way that makes sense then get another opinion.

Daniel Greenwald, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 46 reviews

Rhinoplasty Changes in the Nose from the Front View

Generally speaking, osteotomies of the upper nose do not produce, in and out themselves, a significant change in the appearance of the nose from the front view. There may be a slight narrowing effect but the change would not be dramatic.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 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.