Small Cartilage Bump on Nose - In-office Options to Remove?

A small bump can be improved under local anesthesia, but we would have to see you first for an exam. After that, a discussion can be undertaken as to what to do. A rasping procedure is easy to do under a local anesthetic. Be sure to see a rhinoplasty expert for consultation.

Please consider re asking a question with photographs. Sometimes if there is a small piece of protruding cartilage in somebody's nose, after trauma, microdroplet Silikon-1000 nasal injections may be considered for camouflaging it, and precluding for the surgery. I hope this helps! Sincerely, Dr Joseph

Hello and thank you for your question. I don’t recommend having rasping performed under local anesthesia. This will usually make the nose look better for 1-2 months and then it will actually get much worse long-term afterwards, with contour irregularities developing. This is because the skin of the dorsum is extremely thin. A much better approach is to do a formal revision with rasping and placement of a dorsal onlay fascial graft to help smooth the dorsum. Here is some general advice when considering a surgeon.

I highly recommend that my patients focus much more on real longterm before and after photographs rather than 3D imaging.   I encounter so many patients in my practice who see me for revision rhinoplasty who previously had surgery elsewhere who feel like they were mislead into surgery by surgeons who relied heavily on 3D imaging without adequate real before and after pictures to back it up. Photoshop is easy but real surgery is very different.

I always recommend that you carefully evaluate your surgeon’s online before and after gallery on their website for both quality and quantity of results. Make sure that there are hundreds of real before and after pictures which demonstrate long-term follow up results. If your surgeon is posting mostly on table results without real long-term follow up results, that is usually a major red flag. If a surgeon is posting mostly just splint removal day videos without longterm follow-up pictures, or all patient selfie’s without real longterm in-office formal pictures that can also be a red flag. Long-term results are much more meaningful than on table results or 1 week post-op results. Selfie’s can also be fun to look at, but these can often have a filter and do not represent true longterm results because of this and are not as valuable as real longterm in-office before and after photographs on your surgeon’s website.

With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

A full set of nasal photograph from all angles are required to make a determination about how best to proceed. In most cases, removing a cartilage bump will leave patient with an open roof, flat top nasal deformity, which will look very unnatural. Anytime a cartilage hump is removed, osteotomies placed in the nasal bones will need to be performed to close the open roof created from the cartilaginous hump removal itself. This is performed under general anesthesia and outpatient procedure. Depending upon the size of the hump, spreader grafts may be required to prevent collapse of the upper lateral cartilages after the hump from removal. Spreader grafts prevent the inverted V deformity.