I've had a number of consults for a rhinoplasty. In general I like my nose and my tip but want to fix a slight hump that's really only visible on 3/4 view. Is it possible to fix this with rasping only given I'm otherwise happy with my front view of my bridge and tip?
Answer: Rhinoplasty Hi @Giving4174! This would not be ideal because when the dorsal hump is shaved down, the bridge across the left and right nasal bones will be removed. This leads you with a wide flat bridge and visible left nasal bone and a separate visible right nasal bone also known as an open roof deformity. If you shave just the dorsal hump, the nose will appear even longer on profile. A natural nose is very achievable. A rhinoplasty in my opinion is one of the most difficult procedures to perform. In my practice, I utilize piezosurgery. Piezosurgery is a more gentle technique that allows for greater precision. Less bruising and swelling is common with Piezosurgery. In a typical rhinoplasty, a hammer and chisel technique is performed leading to more inadvertent fractures. Best of Luck, Dr. Nima!
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Answer: Rhinoplasty Hi @Giving4174! This would not be ideal because when the dorsal hump is shaved down, the bridge across the left and right nasal bones will be removed. This leads you with a wide flat bridge and visible left nasal bone and a separate visible right nasal bone also known as an open roof deformity. If you shave just the dorsal hump, the nose will appear even longer on profile. A natural nose is very achievable. A rhinoplasty in my opinion is one of the most difficult procedures to perform. In my practice, I utilize piezosurgery. Piezosurgery is a more gentle technique that allows for greater precision. Less bruising and swelling is common with Piezosurgery. In a typical rhinoplasty, a hammer and chisel technique is performed leading to more inadvertent fractures. Best of Luck, Dr. Nima!
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December 28, 2022
Answer: What you should know about rhinoplasty Thank you for your question and photos. Since you’re only interested in reducing the appearance of the dorsal hump, nasal rasps can be used to file it down safely while preserving the rest of your nose structure. By filing down the protruding cartilage, the slope of the nose can become smoother and more defined. Keep in mind that rhinoplasty of any sort is one of the most complex plastic surgery procedures, requiring experience, skill, and even artistry to achieve an optimal outcome. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon, with expertise in rhinoplasty techniques. They will be able to discuss your aesthetic goals with you and review the steps of your selected procedure.
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December 28, 2022
Answer: What you should know about rhinoplasty Thank you for your question and photos. Since you’re only interested in reducing the appearance of the dorsal hump, nasal rasps can be used to file it down safely while preserving the rest of your nose structure. By filing down the protruding cartilage, the slope of the nose can become smoother and more defined. Keep in mind that rhinoplasty of any sort is one of the most complex plastic surgery procedures, requiring experience, skill, and even artistry to achieve an optimal outcome. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon, with expertise in rhinoplasty techniques. They will be able to discuss your aesthetic goals with you and review the steps of your selected procedure.
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December 22, 2022
Answer: You likely need osteotomies to close the open roof after bump removal. Rhinoplasty is always the surgery of millimeters, and the lower 2/3 of your bridge appears high, both bone and cartilage. Lowering your bridge would lead to nasal widening which is repaired with osteotomies. They don’t hurt and may lead to a narrower nasal appearance. Thanks! Dr Joseph
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December 22, 2022
Answer: You likely need osteotomies to close the open roof after bump removal. Rhinoplasty is always the surgery of millimeters, and the lower 2/3 of your bridge appears high, both bone and cartilage. Lowering your bridge would lead to nasal widening which is repaired with osteotomies. They don’t hurt and may lead to a narrower nasal appearance. Thanks! Dr Joseph
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December 16, 2022
Answer: Can my dorsal hump be shaved down without breaking my nose? While it is possible to rasp a dorsal hump such as yours via access through an internal nostril incision, we have found, over time, that this approach results in a high frequency of secondary revisions. Most commonly, the dorsal hump is composed of both cartilage and bone, each of which is optimally addressed with different instruments and techniques. The precision of such a treatment is optimized by direct visualization. Accordingly, we therefore prefer to take down a dorsal hump, such as the one seen in your photographs, by an open approach, rather than by simply rasping it in a closed fashion.
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December 16, 2022
Answer: Can my dorsal hump be shaved down without breaking my nose? While it is possible to rasp a dorsal hump such as yours via access through an internal nostril incision, we have found, over time, that this approach results in a high frequency of secondary revisions. Most commonly, the dorsal hump is composed of both cartilage and bone, each of which is optimally addressed with different instruments and techniques. The precision of such a treatment is optimized by direct visualization. Accordingly, we therefore prefer to take down a dorsal hump, such as the one seen in your photographs, by an open approach, rather than by simply rasping it in a closed fashion.
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November 16, 2022
Answer: Dorsal hump Most dorsal humps require removal with a rasp or osteotome followed by osteotomies ("breaking the nasal bones") to close the so-called "open roof" deformity that results. There are some bony humps that can, however, be rasped down by a few millimeters without needing to break the bones. Yours may be one of them, though it's a little hard to tell by just a couple of photos. An in-person consultation is best, as the hump can be palpated to see how much of it is bone.
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November 16, 2022
Answer: Dorsal hump Most dorsal humps require removal with a rasp or osteotome followed by osteotomies ("breaking the nasal bones") to close the so-called "open roof" deformity that results. There are some bony humps that can, however, be rasped down by a few millimeters without needing to break the bones. Yours may be one of them, though it's a little hard to tell by just a couple of photos. An in-person consultation is best, as the hump can be palpated to see how much of it is bone.
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