Can my dorsal hump be shaved down without breaking my nose? (photos)

The problem with your particular bridge is that you have widened bumps at the junction of your bony and cartilaginous nasal bridge. If you just shave it down without osteotomies, you could be left with an open roof deformity. So be sure to go to experienced rhinoplasty surgeons for a few consultation.

Thank you for your question. In general, for changes that are seen on a single view, while it is possible to make those certain changes on the view it is key to see that on other views the appearance of the nose changes with that 'single' change... all the best

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!

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.

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

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.

Since you've had consults for rhinoplasty already, you probably already understand that when a hump is removed there is a risk of have a flattened appearance to the nasal dorsum, and that's why dorsal reduction is often done with osteotomies (cuts in the bones to tilt the walls inward to prevent this deformity).
Conservative resection with rasping may be possible in your situation. That being said, you should only entertain this possibility with the following conditions:if while under anesthesia, your surgeon feels that it's an unacceptable appearance and osteotomies are warranted, you should trust your surgeon's expertiseORyou are adamantly opposed to anything further at the time of surgery and understand that this may not be ideal after fully healed and you may desire future corrective surgery and hold your surgeon harmless for this situation.

Hello,
Yes this can be done with closed or open rhinoplasty procedure. Rasping can eliminate the bump but given your thin skin some irregularities might show after surgery. A dorsal preservation rhinoplasty procedure, where the bump in pushed down might be better option for you. It is better to discuss the options with your facial plastic surgeon.

It is often required to perform osteotomies during a rhinoplasty where a significant dorsal hump is taken down. If the hump is very small, it may be possible, but when the hump involves the cartilage and bone of the nose and significant reduction in the hump, performing this procedure without breaking the nose is likely to leave the structures of the nose directly under the skin which can also lead to contour problems. Think of the nose like a TeeP.ee If you cut the top off of the Teepee, you can see the contents of the inside! In summary, osteotomies are a safe procedure to perform and usually go hand in hand with hump reduction.

Photographs cannot show the thickness of the bone, or the position of the junction between the boney part of the dorsum and the cartilage. These are the two factors which determine whether your hump can be re-contoured with rasping only. It would also be helpful to see the side view of your nose from either side. However, an in-person examination is still necessary to advise you.
Obviously, it is preferable to avoid the bruising and addtional recovery from cutting and re-positioning of the bone, but a poor result (widened dorsum and/or visible edges of bone or cartilage) is worse. If I was doing your surgery, I would want the option of doing this if rasping alone did not give a great result. Hope this helps!