Does the removal of a dorsal hump from rhinoplasty heal by callus formation like a broken bone?

Question

Is that what causes a bump on the bridge after dorsal hump is removed? If calluses form, how often do they go away on Their own?

Oakley Smith, MD, FRCSC · Answer

Hi, It is better for you to consult with a facial plastic surgeon who can examine you and give you opinion based on your needs and expectations. Usually they won't go away on their own.

Steve Laverson, MD, FACS · Answer

This is an excellent question, and like so many questions about what happens after surgery, gaps in our knowledge prevent a perfect answer.  In general, removal of the "dorsal hump" of bone, cartilage, periosteum, perichondrium, and perhaps nasal mucosa and other soft tissue leave a variably sized defect on top of the nose.  My protocol is to develop extramucosal tunnels so the defect excludes mucosa and doesn't communicate with intranasal (endodermal) microenvironment.  Surgical and aesthetic convention is to close and reconstruct the osseocartilaginous defect by coapting and aligning  marginal structures with osteotomies, sutures, and/or grafts.  We use the Piezo for osteotomies under direct vision and generally spreader flaps.  If the skin is thin and dorsal contour problems are a risk, we add slivers of cartilage and/or demineralized bone matrix.  Healing is by fibrous and/or osseous union.  Although the nasal dorsum becomes structurally sound over time, it may or may not approach the original nasal resistance to impact.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Even good technique is used, the dorsum should heal with a smooth surface without a visible callus. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Eric M. Joseph, MD · Answer

After we remove a bump from somebody's bridge, osteotomies are typically performed to narrow the nose. In our experience over 25 years, dorsal humps do not grow back although the nasal bones heal in the position that we leave them within 2 weeks after surgery. Thank you for your question. Sincerely, Dr Joseph

Zoran Potparic, MD · Answer

Healing around bone cuts (osteotomies) after rhinoplasty does include formation of callus. However, well executed osteotomies will rarely leave large, visible callus which requires revision.

Mats Hagstrom, MD (license on probation) · Answer

Anytime the body is injured from trauma or surgery. It will heal primarily through an inflammatory response that creates scar tissue.
The scar tissue in broken bones is a little different than soft tissues but the basic concept is the same.
When the body senses less inflammation than scar tissue.
Results from rhinoplasty surgery are usually based on the patient’s candidacy for the procedure combined with the skill of the provider or in other words how well the procedure was performed.
Best,
Mats Hagstrom MD

George Lefkovits, MD - Account Suspended · Answer

After a rhinoplasty when involving the removal of a dorsal hump, a residual hump may indicate that not all of the prior excess bone and/or cartilage was removed. A residual hump  after the swelling has subsided,  which may take months, may also suggest scar tissue. It is, therefore, important to follow up with your plastic surgeon so he can guide you and  suggest appropriate  treatment when indicated.

Jared Blau, MD - Account Suspended · Answer

The removal of the hump involves removing bone or cartilage that is prominent. That doesn’t really need to heal like a broken bone does since it’s essentially shaving down the bony part. Often the next step is that the surgeon performs “infracture” to narrow the bridge. That is where the bones are repositioned, so yes that interface will heal like a normal bone. Luckily the nose doesn’t bear weight like your legs do, so internal plates or external casts aren’t needed for 6 weeks, just have to leave it alone

Does the removal of a dorsal hump from rhinoplasty heal by callus formation like a broken bone?

Answers (8)

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