Rhinoplasty Without Removing Nose Bump?

Question

I am having a consultation next week for rhinoplasty. My concern is I want to keep the shape of my nose. I have a 'bump' on it. I want the length reduced but if possible keep the shape similar as possible (including a bump). Is this possible or does reduction require an alteration which MUST remold the nose to remove the bump as well?

	Can the nose be shortened, but retain the bump? I've yet to see anyone with a nose where the bump is still there. Are my expectations realistic? All answers will be greatly appreciated. Thank you.

S. Larry Schlesinger, MD, FACS · Answer

Rhinoplasties are the quintessence of plastic surgery.  The rhinoplasty (nose job) is truly that aspect of plastic surgery where technique and artistry meet.  The answer to your question is "yes".  You can continue to have a bump or hump on the bridge of your nose and still have an excellent looking rhinoplasty. 

	Because everything has to do with everything, when the tip of your nose is redefined, the bump on the bridge of your nose may need some slight modification to keep it in balance with the rest of your nose.  Be very clear with your plastic surgeon as to what you want to change with your nose and what you want to retain.  Be careful when choosing the plastic surgeon for your rhinoplasty.  This is a very important decision and multiple consultations with Board Certified plastic surgeons will help you decide who can help you achieve the nose you desire.

Sam Rizk, MD · Answer

Your nose job will be tailored to your specific goals
and expectations, considering they are within reasonable range. There is no
such thing as a change you “must” undergo during your rhinoplasty, as the
surgery is a cosmetic procedure primarily designed to make you look and feel at
your best. If you want to keep the bump in your nose for any reason, simply
communicate this concern with your surgeon. He or she should be able to design
a surgery that is right for your, giving you a more aesthetically pleasing look
while being sure to keep your changes subtle and natural. If your surgeon feels that your bump may not look proportionate or in 
harmony with your new changes in your nose then he should communicate 
that with you prior to surgery during your consultation. Having clear
communication with your surgeon is the best way to ensure that your results
turn out as you please.

Tanuj Nakra, MD, FACS · Answer

Hi there!
Sounds like you are hoping to retain the "bump" or the dorsal hump to some degree so that you retain a natural looking nose.  That is a very reasonable request.
The answer is yes, that the "bump" can be retained.  The caveat is that if there is tip work done to the lower lateral cartilages, then there may be some deprojection or reduction of the tip size.  If the nasal tip is deprojected, then the "bump" will actually appear relatively larger.  That's why in almost all cases, some reduction of the dorsal hump is required to rebalance the nose.  The dorsal reduction does not need to be drastic (such as requiring osteotomies, or fracturing the nose), often times a rasp can be used to reduce the projection of the hump to match the tip.
You may want to see pre and postop photos of your surgeon's work.  Remember that you are choosing an artist when you select a rhinoplasty surgeon, and each will have his or her own style.  Try to find someone who matches your style!  Hope this is helpful, and good luck!

William Portuese, MD · Answer

A rhinoplasty can be performed and still leave a hint of a bump on the nasal bridge. In the last 10 to 15 years there has been more of a trend to leave a strong nasal dorsal profile. The old-style rhinoplasty from the 1970s and 1980s was to perform more of a ski slope, which is now out of vogue and out of favor. The important thing is that the nose bridge, middle third, and lower third of the nose including the tip all balance together and fit with the facial features so that it does not appear that a patient has even had a rhinoplasty. The nose also needs to breathe.

Richard W. Fleming, MD (retired) · Answer

When you have your consultation, be very clear about your desires. Most surgeons have done a rhinoplasty leaving a hump in place. This may not give you the best aesthetic result, but it is your nose and your choice. You say you've never seen a nose "where the bump is still there". Hopefully you have seen many noses, with and without humps, where the work is so natural you don't know surgery has been done.

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