For those of you considering having a rhinoplasty to reduce a dorsal hump on the nose, there are several things to consider before deciding to have plastic surgery.
1. Is your dorsal hump due to excess bone, cartilage or both?
It turns out that not all nasal bridge humps are created equal. The bridge is actually composed of bone in its upper third and cartilage in the remaining lower two-thirds.
Some people’s humps are limited to the upper “bony” portion of the bridge. This can be addressed during rhinoplasty by removing the excess bone only.
Other people may have a hump that is due to excess cartilage. This would be best treated by trimming the cartilage that is causing the dorsal fullness.
Probably the most common scenario is a hump that is composed of both excess bone and cartilage.
A combined approach in which the bone is removed and the cartilage shaved needs to be used in this situation.
2. How much reduction do you want?
It is important for you to communicate with your Plastic Surgeon how much of a hump reduction you want. This aspect comes down in large part of your personal preferences and aesthetic.
Some patients prefer leaving a small amount of bridge fullness after surgery. This may be to maintain some ethnic or family features, or just a personal preference.
3. How well will your nasal skin redrape after a dorsal hump removal?
This point relates to the issue of how much reduction to make during dorsal hump removal. Though some level of hump reduction should still be possible, in patients with thick skin it may not be possible to reduce the size of the nose quite as much as desired. This is due to the concern that the skin won’t be able to adequately shrink wrap around the newly downsized nose. The result may be an amorphous blob of skin that would likely make the nose look worse.
4. Do you also need a radix graft?
Your Plastic Surgeon should assess your nose to see if you have a pseudo-hump deformity. This results when the upper bony part of the bridge (radix) is under-developed which leads to perceived excess fullness along the profile line below the radix.
5. Do you need to prevent delayed middle third collapse?
You should ask your surgeon if he or she plans on placing spreader grafts after your hump reduction. It’s important to understand that spreader grafts may be needed even in the absence of pre-existing middle third (internal nasal valve) narrowing or collapse in order to adequately support the upper lateral cartilages after hump reduction.
As the overlying skin and soft tissue shrink wrap after hump reduction, quite a bit of scar contracture occurs. Over the course of years, this can lead to the onset of middle third narrowing or collapse. This can cause unwanted aesthetic and functional breathing effects.
Whether spreader grafts need to be placed during your hump removal depends on how much of a hump is removed and whether the bridge reduction involves the middle third of your nose.
At Peninsula Plastic Surgery, we specialize in Dorsal Hump removal. Get in touch today at 310-326-3636 to see how we can help.
