Should the Surgeon Have Made Osteotomies when Removing the Nasal Hump?

Hello, I had rhinoplasty 6 weeks ago to remove a small hump from my nose. Unfortunately, I am not happy with the result as although my nose looks smooth from profile view, from the front view there are still bumps either side of where the original hump was removed. These bumps are causing my nose to still look like it has a hump from the front view as well as making my nose look wider. Please could you tell me if my surgeon should have made osteotomies and pushed the nasal bones together?

Doctor Answers 8

Do you need osteotomies after hump reduction?

The quick answer is "it depends".   A small hump reduction, primarily of the mid third cartilage and just a rasping of the bone with no "open roof deformity" ( that is, the rounded contour of the bone, while reduced in size and projection, is maintained in shape) does not require osteotomies.  However, if the width of the nose is too wide from the front, then osteotomies would help narrow the nose from the front, whether you've had a hump reduction or not. Hope this is helpful.

New York Facial Plastic Surgeon
4.7 out of 5 stars 80 reviews

Hump removal

With most hump removals, osteotomies are performed.  Ask your surgeon if they were done. Noses tend to be very swollne for months after surgery.  Give it time to heal.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Osteotomies are not always required following rhinoplasty with hump reduction

Osteotomies are not always required following rhinoplasty with hump reduction. In some cases, with a small dorsal hump, rasping the bridge of the nose creates a smooth profile without resulting in an "open roof." If the nose does not need to be otherwise narrowed osteotomies are not required in these cases. With regard to your photos, 6 weeks is still early to assess your final result due to swelling. If your concerns persist, return to your surgeon to have your questions answered in person and determine if anything can be done now or later to address your concerns.


Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

You pictures do not show the need for osteotomies

You have a good results based on the limited views and 6 weeks post surgery. You do not have wide base and do not need the do osteotomies. Give it time to heal .

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

Rhinoplasty may not require fracture

Though most often when the hump is removed the nose is shaped with osteotomies, or careful cuts in the bone to allow a gentle curve as the bridge is seen straight on, a few individuals may have a very narrow bridge even with hump removal and rasping may shape the nose without a fracture. At six weeks the bridge may still feel full and thick, so wait a month or two more before you judge your result.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Should the bones be broken during a rhinoplasty

From the one view you showed it is impossible to give you an answer. An examination of your bones, and closer look at multiple angles of your preop photos would be required. osteotomies are required when an "open roof" is created after removal of the bump on the dorsum of the nose. If the nose at that point is wide and you can feel the 3 bones, then closing the open roof or osteotomies are indicated.

Your surgeon made that determination based on preop and intra operative examination. small irregularities you do not like on your nose now, can be improved. Return to your surgeon to discuss options such as injections.

Rick Rosen, MD
Norwalk Plastic Surgeon
5.0 out of 5 stars 22 reviews

Rhinoplasty and Osteotomies

Hello Summerbee,

You are six weeks from your surgical procedure so you nose is bound to look wider.  Has your doctor told you that he did not perform osteotomies?  The photo you posted cannot reveal if osteotomies were performed or not, but they do show swelling around the mid face, as one might predict.

I would try to be more patient before you decide you don't like your result.  Usually around three months is a good time for you and your doctor to assess the nose for the first time to discuss possible issues that may exist.

Best of luck.

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews


When removing a dorsal hump, osteotomies are almos always required. They close the open roof created by the osteotomies.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.