Rhinoplasty: Cost, Pics, Reviews, Q&A

Trust Your Surgeon’s Advice

It is not uncommon for a patient to have misgivings about certain elements of a surgical procedure. However, in Rhinoplasty, it is far better to follow your Surgeon’s advice and to allow him/her to “do the right thing” when performing your Rhinoplasty; it would be far better to do nothing than to try to dictate the specific maneuvers in your surgery.

In your specific case, reduction of the dorsal hump without osteotomies will create a flat shelf-like appearance on the top of your nose that could look worse aesthetically.

You may also need augmentation at the nasion (where the nose takes off from the glabella) once your hump is reduced. (Stephen Prendiville, MD, Fort Myers Facial Plastic Surgeon)

File nose only

Not a chance with your nose! Just from the profile it looks like you have too much of a dorsal hump. When you rasp it down it will look very wide and in order to provide nice nasal lines, you would need osteotomies.

Do not focus so much on limiting your surgeon’s ability to give you an excellent result. (Steven Wallach, MD, Manhattan Plastic Surgeon)

Augment the radix, instead of shaving the dorsal hump

Your profile shows a straight dorsum with a low “root” or radix. The tip is well defined and the nasolabial angle harmonizes with your face.

Nose hump removal without surgery rhinoplasty

Prior to contemplating rhinoplasty, why not augment the “dip” above the “bump” with a Hyaluronic acid. While the result will not be long lasting, it may allow you to “try it before you buy it”. If you decide to reduce the dorsal hump, I think that an osteotomy would be essential as your nasal skin is thin and any irregularities would be definitely worse than an osteotomy. (Lavinia K. Chong, MD, Orange County Plastic Surgeon)

You have too much dorsal hump and reduction of the nasal bone will leave flat dorsum. Please let your plastic surgeon do what needs to be done to get the perfect result. I would like to know the reason for opposing the osteotomy. (Kamran Khoobehi, MD, New Orleans Plastic Surgeon)

Fixing a dorsal hump without osteotomy.

Nose hump removal without surgery before and after

Removing the hump will leave the sides of the triangle too far apart and that is why you will need osteotomies. This is not painful and will give you a better result. See an experienced rhinoplasty surgeon to discuss this. (Toby Mayer, MD, Beverly Hills Facial Plastic Surgeon)

Fixing the Dorsal Hump on my Nose Without an Osteotomy

Thanks for the photo side view. Your answer is NO! Removing hump will leave an “open roof” deformity that can be closed by osteotomies. Seek in person opinions. (Darryl J. Blinski, MD, Miami Plastic Surgeon)

Leave it up to the doctor

You are not an expert in rhinoplasty, tell the doctor what you want and then don’t tie the experts hands. Let him or her do what is needed. You will be asleep and nothing will hurt no matter what is done. (William B. Rosenblatt, MD, New York Plastic Surgeon)

Nose hump removal without nose job surgery

Nasal humps can be reduced without fracture

It is true that in some instances it is possible to reduce the hump on the nose without completing nasal fractures. Often though hump reduction will produce a flat area on the bridge much like cutting off the top of the letter A. The purpose of the fracture is to adjust the width of the bridge, and to straighten the nose if needed.

These fractures can be done very gently, with multiple perforations in the thin bone, and a ‘greenstick’ fracture to flex the bones into position. I think there is little to fear from this step in the rhinoplasty procedure. You should require a splint, fracture or not, as this primarily controls swelling.

There is no need to change anything else in your nose if you don’t want, but I wouldn’t be over concerned about the fracture. (Peter E. Johnson, MD, Chicago Plastic Surgeon)

Performing rhinoplasty is a balancing act. I view the nose in terms of proportions. If one aspect of the nose is altered many times the other portions of the nose become disproportionate.

Example, If only your dorsal hump is removed then on the frontal view the nose will appear wider WITHOUT osteotomies. Additionally, I believe that if you only remove the hump on your side view your tip area would look larger and more projecting.

Listen to the recommendations that you get from your surgeon. (Earl Stephenson, Jr., MD, DDS, Atlanta Plastic Surgeon)

Removal of Hump without Osteotomies

Your nasal hump can be minimally reduced if you don’t want do osteotomies. To achieve a straight dorsum (or profile line) you will have an unnatural wide bridge unless the osteotomies are done.

See an experienced surgeon who will clarify your options and establish expectations. (Richard W. Fleming, MD, Beverly Hills Facial Plastic Surgeon)

Improving Dorsal Hump without Osteotomy

Generally it’s not possible as other plastic surgeons have stated. Small bumps may be rasped down, but larger bumps require more bone & cartilage reshaping. Bone reshaping is performed with osteotomy, or controlled cuts in the nasal bones. Bumps on the nose are made of cartilage and bone. Typically, bumps are reduced, and occasionaly parts of profile are filled in to match the bump. Speak with a rhinoplasty surgeon to perform a comprehensive evaluation and to help determine appropriate options for you. (Houtan Chaboki, MD, Washington DC Facial Plastic Surgeon)

Avoiding Osteotomies With Nasal Hump Reduction

In my opinion I don’t think it is likely you will be able to avoid osteotomies after reducing your dorsal hump. Most patients and rhinoplasty surgeons would likely aim to bring down your bridge a fairly moderate amount. In fact, many surgeons would also agree that your tip needs to be brought closer to the face. When you rasp the bridge down to such a degree, you really do need to perform osteotomies in order to maintain an appropriate width as seen on your frontal view. If not, you are risking having your nose look wider than desired. I wouldn’t be so concerned about avoiding osteotomies when they are warranted. If the hands of an experienced rhinoplasty surgeon, osteotomies can be performed with minimal swelling and little added healing time. (John M. Hilinski, MD, San Diego Facial Plastic Surgeon)

I think you would be happier with the results if ostetomy is performed.

Although I understand your desire to avoid osteotomies, “filing” of the hump withour osteotomies would leave what we call an “open roof deformity” that will give you a flattened and unnatural appearance.

You would be happier with reshaping of the whole nasal dorsum.

You could rasp the dorsum a small amount without obtaining an open roof but I don’t think you will see much difference. (Marisa Lawrence, MD, Atlanta Plastic Surgeon)

Removing your dorsal hump would likely require osteotomies.

You appear to be an excellent candidate for Rhinoplasty Surgery, based on your profile photo. Your dorsal hump is bony at the top, and mostly cartilaginous from your mid-bridge down. Your tip is a bit overprojected, and your nose is a bit long. You would likely benefit from hump reduction, along with nasal shortening, and tip deprojection and rotation. Osteotomies would be necessary to narrow your nose on the frontal view: your bridge will widen after the hump is removed. Osteotomies cause mild bruising, but are likely necessary and will not add to post-operative discomfort. I’ve attached a link to some photos I posted on RealSelf. The first 2 patients have noses simillar to yours. (Eric M. Joseph, MD, West Orange Facial Plastic Surgeon)