Are dorsal hump procedures more painful than others?

Question

Like many others on this forum, I have a small dorsal hump on the upper part of my nose bridge, and I'm curious about the pain? It seems like filing/shaving/rasping is the most common method for this issue, and I'm wondering if shaving of the bone is especially painful compared to other rhinoplasty procedures?

Michael R. Macdonald, MD · Answer

Some swelling and bruising is normal and expected.  These side effects vary by patient, but discomfort is usually minimal.

Afshin Parhiscar, MD · Answer

Dear hanahan111In general, rhinoplasty is not a painful procedure but rather an uncomfortable procedure as it often impacts your ability to breath through your nose in the early postoperative period. Dorsal hump reduction is often accompanied by osteotomies. Again they are not usually painful but generally can lead to swelling and bruising around the eyes.

Toby Mayer, MD · Answer

Removal of the home with rasping or filing etc. sounds very painful but in fact is not. Pain after rhinoplasty is minimal and many patients do not take anything stronger than Tylenol. See a very experienced surgeon for the best results.

David Gilpin, MD · Answer

Thank you for your question. In general, pain from a rhinoplasty or other nasal procedures should be reasonably controlled with pain medications afterwards.  In my experience, a smaller procedure, such as nasal rasping, is not as painful as a complete rhinoplasty. However, pain thresholds are different for each patient.  I would suggest that you consult with a board certified facial plastic or general plastic surgeon who specializes in rhinoplasty to discuss your concerns and goals for your procedure. I hope that this helps!-David Gilpin

Chase Lay, MD · Answer

In general no BUT if your rhinoplasty requires additional maneuvers like osteiotomies there is a tendency for more discomfort as well as swelling and bruising.  Two of the best surgeons to talk to in the Bay for something like this may be Umang Metha, MD or David Kim, MD.Chase Lay, MD

William Portuese, MD · Answer

The dorsal hump is composed of both bone and cartilage. The majority of the hump is usually  about two thirds cartilage and one third bone. Once the hump has been removed, osteotomies are required to be placed in the nasal bones to close the flat top, open roof deformity created from the hump removal. The osteotomies are painful to perform during the surgery, and for that reason we place patients under general anesthesia  By a board-certified  physician anesthesiologist for patient safety and comfort. Afterwards, there is very little pain inside the nose unless  your physician packs the nose or places stents in side the nostrils.  In our practice, we avoid placing stents and packing inside the nose since they're unnecessary. For many examples and more information, please see the link and the video below

Richard W. Fleming, MD (retired) · Answer

During surgery a patienshould have no pain if proper anesthesia is administered. Pain in the  nose following rhinoplasty surgery is not severe, short lived and controlled with pain medication. I suggest you not worry about pain after this operation.

Vincent D. Lepore, MD (retired) · Answer

In most cases, I would suggest that if a patient has a dorsal hump resection with rasping and/or osteotomies (cutting the nasal bones) the procedure be performed under general anesthesia.  It is possible to perform hump resections under local anesthesia with some sedation, as well, however some patients don't tolerate the sound or vibration associated with rasping/cutting of the nasal bones.  However, once the surgery has been completed, most patients have very little pain following a rhinoplasty, even if the nasal bones have been cut.  Best wishes, Dr. Lepore.

Jon A. Perlman, MD (retired) · Answer

Removal of a dorsal hump nearly always requires infracture of the base of the bones to narrow the bridge and close the roof. This does result in some swelling and bruising that is uncomfortable but not particularly painful and should not be feared. Without the need for packing and with open airways after surgery the experience is usually not unpleasant and is quite tolerable. Please watch the video above for additional information about recovery after rhinoplasty. Good luck and enjoy your results.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic
Surgery (ASAPS)
Beverly Hills, California

Michael Elam, MD (retired) · Answer

Dear hanahan11, Filing, rasping, and any form of hump removal during rhinoplasty surgery is not painful. Reducing the dorsal hump is a common part of most rhinoplasty procedures and this has no bearing on the the patients recovery versus someone who did not have any dorsal refinements. Rhinoplasty surgery is a procedure that has very minimal discomfort for the majority of patients. Most patients complain about stuffiness the first night and rarely have further discomfort and certainly none that is not handled by mild pain medications for the first few days of recovery. Best regards, Michael V. Elam, M.D.

Are dorsal hump procedures more painful than others?

Answers (10)

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