Revision Rhinoplasty for a Dented Flat Nose for Non Osteotomy?

I had nose surgery 2 months ago for hump removal. The surgeon said I did not require an osteotomy--maybe he's in denial. He removed the hump which I'm happy about, but now I have like a dent on the center of where the hump was removed. It looks kinda flat from vertical angle too also slightly wide. The flatness and dent is minor, but noticeable nonetheless.

Can the surgeon just perform an osteotomy or would a complete revision rhinoplasty be needed? The photo shows a bump, but it's just the wide nose. You can't see the dent, but it's there.

Doctor Answers 6

Likely need osteotomies

When a hump is removed, it is similar to taking the top off of a mountain.  You get a plateau.  This plateau makes the nasal bridge broad.  This is called a open roof deformity.  In order to close the open roof deformity, you perform lateral osteotomies to close the plateau.  It is not as simple as just doing osteotomies now because fibrous tissue has probably filled in the gap and will prevent the nasal bones from completely infracturing and closing the plateau.

Houston Facial Plastic Surgeon
4.6 out of 5 stars 90 reviews

How to fix a dent after hump removal

Sometimes when only the hump is removed the edges of the nasal bones don't meet. And with thinner skin like your this is more likely to be noticeable. The treatment is lateral osteotomies.

Oakley Smith, MD, FRCSC
Toronto Facial Plastic Surgeon
5.0 out of 5 stars 93 reviews

Wide nasal bridge following rhinoplasty

The lateral osteotomy can be performed percutaneously with relatively minor surgery. However, the advantage of performing this at the same time of the rhinoplasty is that the skin on the bridge of the nose has been lifted off of the bone. IF the osteotomy alone is performed and the bones are brought inwards with a closed or minimally invasive technique, there is a potential to pinch the skin between the narrowed bones.

In any event, it should be a relatively minor surgical procedure lasting less than an hour.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 82 reviews

Revision Rhinoplasty


It sounds like an open roof deformity. This can be corrected with ostetomies. However, if the sides of the bump are protruding they may also have to be shaved in.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 274 reviews

Flat bridge after hump removal

The most common problem after hump removal without osteotomy is an open roof deformity. This represents the area between the nasal septum and the bony sidewalls.

In order to correct this a second surgery with osteotomies is usually necessary. It does not mean that the entire rhinoplasty must be repeated.

The picture you provided does not really tell the whole story. This answer is in reponse to your written decription.

Ira D. Papel, MD
Baltimore Facial Plastic Surgeon
4.9 out of 5 stars 31 reviews

Revision rhinoplasty

 I really can't see what you are talking about from the photo but it sounds like an open roof deformity which can be improved by infracturing the nasal bones without re-doing the entire surgery.  If it is minor enough, perhaps some temporary fillers might help and would avoid surgery.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

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