What is the Procedure for Shaving Down a Bone Bump Left from Rhinoplasty Healing?

I had closed rhinoplasty about 8 months ago. (deviated septum, broken nose, hump) At my 6 week post-op visit, my doctor said that it appeared the bone had grown back kind of one piece on top of another on the top part of my nose. He said to wait about 6 months and then I could come back and it could be fixed in the office. The bump is still there but I am a little worried about getting it fixed..."shaving it down" while I'm not completely asleep sounds pretty horrible! How bad would this be?

Doctor Answers 11

What is the Procedure for Shaving Down a Bone Bump Left from Rhinoplasty Healing?

The best procedure for you is the one that makes you the most comfortable.  With that in mind, taking down a bump on the nose can be done under local anesthesia, but you should consider a bit of sedation at the same time.  

For more information, please go to my website at:
WirthPlasticSurgery.com


Orange County Plastic Surgeon
5.0 out of 5 stars 9 reviews

Minor bump revision

A minor bump revision can be performed internally (closed) under light IV sedation - local anesthesia may be OK for some but not my choice

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 208 reviews

Procedure for shaving down post rhinoplasty bump

There is approximately a 10% revision rate for the rhinoplasty procedure. The most common reason for a revision after a primary rhinoplasty is to file a small bump down on the bridge of the nose. Sometimes the bump is comprised of bone, sometimes cartilage, and occasionally even both. This is simply a reflection of the healing process along the bridge and settling that occurs with the skin envelope of the nose. While shaving of a small bump down is a minor procedure, it is difficult to get the nose completely numb and can be rather uncomfortable trying to do this under local anesthesia. The nose has many different nerve endings and is difficult to completely numb up. It is painful to numb up the nose under local anesthesia to accomplish its minor touchup procedure. It is best to usually have even touchup procedures done under a very brief 15-minute general anesthetic.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 125 reviews

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Revision Rhinoplasty with Local Anesthesia

Shaving a small dorsal bump or rasping an irregularity can be done under local anesthesia.  Request sedation or a light general anesthesia if this does not appeal to you.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
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Revision rhinoplasty

A simple dorsal rasp to revise an irregularity may be easy enough under local, but you may be more comfortable with sedation.

Steven Wallach, MD
New York Plastic Surgeon
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Wait time is 12 months

Getting a less than adequate revision can only make things worse.  First of all 6 months is way too early for going back into the nose.  The proper time to wait is at least 12 months so your doctor is rushing in for no reason and it can complicate things.  If your surgery was done in the hospital or surgery center then the revision should also be done the same way.  Office's are not equiped for proper meticulous rhinoplasty surgery.  Do more research and be careful.

Shervin Naderi, MD, FACS
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 95 reviews

Revising a residual dorsal hump is fairly straight forward

Hello, and thank you for your question regarding persistent dorsal fullness at 8 months.

Without photos it is difficult to fully address your concern for a touch up procedure. 
With that said, it is not uncommon to regain some dorsal fullness as one heals from a dorsal reduction.  This can be often attributed to:

1. Residual swelling (this should improve over time) from the trauma of surgery.
2. Development of scar tissue (if in the bony region of the dorsum this is referred to as 'callous') as you are healing in the area operated on (this may be improved by massage and softening, but may require a touch up).
3. Formation of callous at the bony portion of the dorsum (this will require a touch up most likely)

In the event that a touch up procedure is necessary, I recommend patience to allow sufficient time (from 7 to 12 months from procedure), and that the tissue is once again supple and softened.

I hope this helped, and good luck with your healing

Sergio Pasquale Maggi, M.D., FACS
Austin Plastic Surgery Center
drmaggi.com

Revision rhinoplasty for nasal bump

After a large hump on the nose is taken down, either a new bony callus formation can give some of the "bump back" or sometimes as swelling subsides a remaining hump can be seen.  

These are best corrected in the operating room where a rasp, or file, is used.  It is a very short procedure.

Rhinoplasty revision

Dorsal hump can be rasped, but the skin need to redrape back nicely which may mean elevating the skin to allow it to redrape.

If your concern is the anesthesia you can ask to be put to sleep, general anesthesia.

Sometimes what seems a small problem require a major procedure to get the best results otherwise you will end up with worse results.

Have another opinion

Samir Shureih, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 6 reviews

Bony hump on nose came back

6 weeks after rhinoplasty your swelling has only subsided about 50%-60% .  The skin over the dorsum or over the hump is the thinnest skin on the nose and should come down even more.  In addition, this skin probably swelled more than other surrounding skin as taking down a hump can cause some trauma to this area of the skin.  Your best bet is to wait at least 9-12 months depending on your skin type - thicker skin takes longer to contract and shrink. 

Nevertheless, the nasal bone can regrow due to something called an osteoblastic response.  This is typically seen in younger patients.  Sometimes a revision needs to be done at 9-12 months to shave the hump down once more.  This can typically be done closed under twighlight or general anesthesia. 

Etai Funk, MD
Houston Facial Plastic Surgeon
4.8 out of 5 stars 49 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.