Correction Possible for my Dorsal Hump?

Question

I have a hump on my nose and I want to get it removed. Is my nose a candidate for only the removal of the hump or would more work be recommended? With the size of my bump how difficult would the procedure be, and how much would it cost? Picture included.

Otto Joseph Placik, MD · Answer

Your side view indicates the presence of a small osseocartilaginoius hump which could be managed with a reduction. The decision to do more depends on your desires. Generally  management of the tip will be completed if you desire a change in the appearance.
Costs will vary  tremendously depending on several factors.

C. Spencer Cochran, MD · Answer

Removal of a hump on the bridge of the nose (dorsal hump reduction) can create a dramatic improvement in the profile. It is possible to remove only a hump from the bridge. This can be accomplished by rasping (filing down) the hump through incisions made on the inside of the nose (closed rhinoplasty). Usually, if a hump is removed, the nasal bones must be surgically broken (osteotomies) to narrow the nose and close any gaps created after the hump is removed.
However, in order for the nose to appear natural and attractive, the nose must have certain proportions in terms of its length and its projection.  Sometimes, filing down the nose (while improving the hump) can cause the nose to look unnatural or "operated on".  This may require some adjustments in the other areas of your nose to keep it proportional and in balance and harmony with your other facial features. These other changes may include decreasing the tip projection or the amount of rotation.
Seek the advice of a surgeon who specializes in rhinoplasty. Many rhinoplasty specialists can show you with computer imaging techniques what your potential result would look like.

Eric M. Joseph, MD · Answer

The picture you posted only shows a single view of your nose, so it's difficult to tell what would be your best option. It seems that your tip is overprojected (comes out too far from your face), and you might benefit from a rhinoplasty to address the bump, and to address your tip.
You should consult a board-certified, experienced rhinoplasty surgeon with many favorable photos.
I hope this helps, and best regards.

Michael A. Persky, MD · Answer

Hi Leah,
Yes, your dorsal nasal hump may be removed. I would advise a subtle rhinoplasty. Your hump can be rasped down (like using sand paper, but stronger). After taking down the hump, your nose would need to be re-evaluated to determine if other maneuvers would be necessary to give you a well balanced nose in harmony with your face.
I have put the cart before the horse though. First it is essential for you to be evaluated by a rhinoplasty specialist who will examine your nose and make a proper diagnosis of what is causing the problem that is bothering you. Then your surgeon should create a plan to address the problem and know before surgery what else may be required to meet your desired result.
The size of the hump does not determine the "difficulty" level of rhinoplasty, nor the cost. The more experienced a rhinoplasty surgeon is, the more they know that there is no such thing as an "easy" rhinoplasty. Your cost will vary depending on the skill and experience of your surgeon as well as geographic location, anesthesia costs, and operating room fees.
Take your time and choose your rhinoplasty surgeon carefully.
Be well.
Dr. P

Toby Mayer, MD · Answer

The pictures you have supplied don't tell the whole story. Sure, just the bump can be removed. It would be a better idea to have your nose evaluated by an experienced rhinoplasty surgeon whose work looks good to you.

David W. Kim, MD · Answer

Almost everyone who seeks removal of a nasal hump does so in order to make the nose look smoother on profile. With that assumption, there are several important things to remember when one is looking to improve the profile of the nose.

	1. If a hump is removed, several other things happen to the nose which may require additional measures. For example, if the bone and cartilage of a hump is removed, the bridge of the nose is essentially "uncapped". There may then be an open space and increased width to the bridge. This typically is treated by cutting the bone to narrow the bony part of the bridge and using cartilage grafts to close the open space of the cartailge part of the bridge (below the bones).

	2. If the bridge is lowered a lot, there can be excessive skin that will not easily drape back onto the lowered nasal skeleton. This can cause unwanted fullness of the skin over the lower part of the bridge, the so-called polybeak deformity. When one has thick, stiff skin and a large hump, it may be better to be more conservative with hump reduction and elevate the bridge above the hump and bring the tip forward. An ideal profile is one in which the root of the nose, the bridge and tip and aligned favorably.

	3. The more a bridge is lowered, the wider the nose looks on the front view. Someone with a narrow nose to start with may look fine after the nose becomes a bit wider. But someone with a wide nose and a high brige or hump may look too wide after surgery. In these cases, the front view suffers in order for the side view to look better. My belief is that the front view is more important. After all, we don't interact with others turned 90 degrees to them!

	4. Other facial features can contribute to the overall profile of the face. In your photo, I notice that you have a slightly undersized chin for your face. By increasing the projection of the chin, the overall facial profile would be in better balance. The smaller the chin, the bigger the nose looks.

	Fees vary a lot around the US. $5-10K is a realistic range.

Steven J. Pearlman, MD, FACS · Answer

It is difficult to give an definitive opinion based on one view. You certainly have a bump, but it also looks like the tip of your nose sticks out a little too far as well. Other views would show this better. This is why not only are more views necessary. This is why I like using computer imaging to demonstrate when a hump removal alone would work and when it would make the nose look  out of balance, then the differences and alternatives can be discussed in better detail.
It is also hard to quote a fee since you might need more than just a "simple" hump removal. I perform a lot of revision rhinoplasties and what I hear often is that the original surgeon said it would be a "simple" procedures. All noses are different and each needs to treated individually as well as evaluated in person to give a full answer about what needs to be done.

Vincent N. Zubowicz, MD · Answer

The aesthetic complaint you have with your nose is common and easy to correct.  I use video imaging as a component of assessment and education the patient.  We can do the operation on the computer and make certain that the patient and surgeon have similar goals.
The cost of a rhinoplasty is $5450 which includes all fees (surgeon, anesthesiologist, facility) and office visits. This should be close to the national average.

Tanveer Janjua, MD · Answer

Yes, it is removable. It will involve shaving down the cartilaginous and the bony part of the hump. After that is removed with a chisel, your nasal dorsum will be a bit flat instead of being narrow. To make it narrow again the nasal bones are broken on the sides called (Osteotomies) and then both bones are pushed towards the center. That gives it the same narrow appearance as you have now but the hump is gone.
The usual recovery time is one week. Bruising varies but can last up to 2 weeks. You will need one week off from work and/or school.
It is not a difficult procedure.
The cost varies anywhere from $2500 to $10,000 depending on the gegraphic area.
Regards

Manish H. Shah, MD, FACS · Answer

Hi Leah,
Thanks for your question.  Removing the hump alone is possible but rarely, since it often widens the look of your nose.  Occasionally a break in your nasal bones needs to be made surgically (osteotomy) to renarrow this widened appearance.  Also, if the width of the upper part of the nose is narrowed, the tip structures often have to be changed to proportionally reduce the appearance of the nose.  This keeps the tip from sticking out too much visually.  Proportion and balance are the keys to a quality rhinoplasty surgery.
Good luck.
Dr. Shah