Is Nose Hump After Septoplasty Just Swelling?

Give it a little time. When surgeons rasp (file down) a hump on the bridge of the nose, it will typically remain swollen for several weeks afterward. Your surgeon should be able to tell you whether or not the amount of swelling is normal. If there is still a residual hump there after 6-8 weeks, you may need to have it filed down some more.

In the immediate post-operative period it’s difficult to
differentiate residual swelling from residual nasal deformities for a variety
of reasons.In the vast majority of
patients, these deformities are subtle, while the associated swelling resulting
from surgery is often severe.For these
reasons, it’s important to allow time for swelling to resolve, before making
decisions regarding revisional surgery.In most
patients, concerns about contour irregularity and asymmetry resolve as swelling
slowly disappears.Under these
circumstances, nothing needs to be done and patients are ultimately happy. In rare cases where nasal deformities persist
after the residual swelling resolves, revisional surgery may be necessary.When this scenario arises, we generally like
to wait at least twelve months before performing secondary surgery.

It is not unusual for swelling after rhinoplasty to give the appearance of a hump on profile. This usually will resolve as the swelling improves.   However, the vast majority of nasal humps are mostly cartilaginous.  Simply rasping the bone rarely completely smoothes a hump. 

Sometimes after septoplasty the cartilage portion of the bridge of the nose can collapse and cause a hump (actually a pseudohump). This is called a saddle nose deformity. It can be prevented by some of the septoplasty techniques performed through an open rhinoplasty approach.

 If your surgeon went in and "rasped" the bridge this is actually a rhinoplasty, not a septoplasty. A septoplasty  is performed through the nostrils into the back portion of the nose to remove obstructing and twisted bone and cartilage blocking air flow through the nose. The septoplasty performed for medical necessity and is billed  to the patient's insurance. Changing the shape of the nose, such as removal of a hump, is considered a rhinoplasty. The hump on the nose is composed of the bone and cartilage and can be rasped or shaved down. Most the time  once the hump has been removed, osteotomies of the nasal bones are required to narrow the bridge line.  For many examples of hump removal with a closed rhinoplasty approach, please see the link and the video below

In general, some amount of swelling after a rhinoplasty is normal and can take several months if not a year to resolve. In some cases, you can get some abnormal scarring of the dorsum of the nose and may need steroid injections to resolve the problem. I would speak with your surgeon about your concerns and ask if he thinks that steroid injections would be helpful.

In general, the swelling takes a full year to go away but you can start to get an idea of what you are going to see after a few months.  The persistent bump could be real or just an artifact but let your doctor guide you through your healing process.