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

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.

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.

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