Bump on nose - could this be an inflammatory/sinus issue or is it only cosmetic? (Photos)

Your nose is featured by a set of atypical anatomical elements, it is a very rare case of rhinoplasty (nothing to do with sinuses) for either being congenital abnormalities or either the combination of them in one single case is atypical as well; to be brief:
-bilateral, total and sever in degree inversion / concavity of lower lateral cruras; that pinched look with sunken sides of tip is very rare to see in caucasians, being a common feature in Middle Eastern people (KSA, KW, PK, etc)
-double hump with sunken middle vault
-long, undefined and hooked nasal tip, which is boxy in shape
-very thin sking allowing transparencies, any tiny imperfection of rhinoplasty might be seen (eventually a superficial temporalis fascia grafting to blanket-mask the entire nose might benecessary, to be decided introp

9/10 primary rhinoplasty difficulty, needing a full re-structuring and plenty of grafting techniques, do research well the talent and devotion to complex structure rhinoplasties of your surgeon.

In the link attached you'll read and view about concave lateral cruras.

When you *feel* the bump, it feels hard, just underneath very thin skin. You can slide the skin left and right across the bump and feel its shape better, too. That bump is right where the nose stops being made of bone (in the upper 1/3) and starts being made of cartilage (in the lower 2/3). It would be lowered with a rhinoplasty. If you were to consider that, I'd recommend also considering elevating your tip. You have a bit of a long-ish nose, and if *only* a bump is removed, it can make the nose *look* longer.

How *much* to elevate the tip, or lower the bump, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery.

Thank you for sharing your photos and detailed history. I completely understand why you’d want clarity here, any change on the face, especially the nose, can feel concerning, and it’s natural to wonder whether it’s purely cosmetic or if there’s something more going on medically.

From your pictures, the bump you’re describing looks more consistent with a structural or cosmetic change in the cartilage or bone of the nose rather than something inflammatory, infectious, or sinus-related. Sinus or inflammatory issues typically cause other symptoms—such as congestion, facial pressure, pain, swelling, or redness and those tend to fluctuate over time. In contrast, a fixed bump on the bridge of the nose that hasn’t changed much in size or caused sinus symptoms is usually a normal anatomical variation or a result of past trauma (even minor trauma that you may not remember).

I recommend plastic surgery for these kinds of concerns because fillers or lasers won’t address bony or cartilaginous irregularities. That said, it doesn’t sound like this is something dangerous or related to sinus disease. If you were having frequent sinus infections, nasal obstruction, difficulty breathing through your nose, or swelling/redness that changes, then a sinus or ENT (ear, nose, throat) evaluation would be reasonable.

The good news is that what you’re noticing doesn’t look worrisome from a health standpoint. It appears more likely to be a cosmetic or structural issue rather than a medical one. It’s completely valid to feel self-conscious about it, and there are surgical and nonsurgical cosmetic options if you ever decide to address it, but it doesn’t look like a sign of underlying sinus disease.

Based on what you’ve shared, this bump looks much more cosmetic/structural than medical. If no sinus-related symptoms are present, there’s no strong reason to suspect an inflammatory cause.