One of the most frequently performed types of rhinoplasty is the classic hump reduction of the dorsal hump on the bridge of the nose. While many patients think it’s easy just to shave the hump down, it takes the skill and expertise of a facial plastic surgeon who specializes in rhinoplasty, to successfully reduce the dorsal hump while making the nose look good without creating other issues.
- Is the hump due to excess bone, cartilage or both? The upper third of the bridge is comprised of bone, while the lower two thirds is cartilage. If the hump is present in the upper portion of the bridge, bone removal will be performed with special surgical files, called rasps. If the hump is located in the lower area of the bridge and is a result of excess cartilage only, the cartilage can be delicately trimmed with special scissors or scalpel blade. Most patients have a combination of both excess bone and cartilage which requires a combination of the two approaches mentioned.
- How much reduction does a patient want? This is a very important conversation that must take place between the facial plastic surgeon and patient. It ultimately comes down to personal preference. Some patients want a dramatic improvement, while others want a conservative result. Digital morphing can be used to demonstrate how a person may look with varying degrees of hump removal.
- Is a radix graft needed? During the evaluation, Dr. Corrado will assess your nose to determine if you have a pseudo-hump deformity. This is when the upper portion of the bridge (radix) is underdeveloped. This leads to the nose looking fuller from the profile view below the radix. A radix graft will create better balance.
- Are spreader grafts needed to prevent future complications? If an individual has pre-existing middle vault narrowing or collapse, grafts will be needed to provide the necessary support to the upper lateral cartilages. For those without this issue, the need for spreader grafts will depend on how much of the hump is going to removed, with typically larger hump reductions requiring the placement of spreader grafts to prevent future issues. As the nose skin and soft tissues shrink after hump reduction, scar contracture occurs which can lead to middle third collapse or narrowing in the future. This can lead to breathing and aesthetic issues. The spreader grafts provide the support needed to prevent this potential complication.
It takes more than just simply taking down the hump on the nose to properly perform a hump reduction.
The steps Dr. Corrado takes when performing classic hump reduction include:
- Reduce the size of the hump.
- Perform osteotomies to reposition the nasal bones to close the “open roof” which results after hump reduction.
- Possibly place a radix graft and/or spreader grafts depending on the specific case.
- Re-align the tip projection and rotation to look good with new bridge height.
Classic hump reduction can be a very rewarding procedure when executed properly by a skilled board-certified facial plastic surgeon. Reducing a hump on the bridge of the nose provides better facial balance and softens the overall appearance. For individuals who are concerned about losing the ethnic appearance, a conservative approach can be taken to ensure delicate improvements are made while maintaining a nose that still represents a person’s heritage.
For more information about Classic Hump Reduction or other rhinoplasty techniques, contact facial plastic surgeon Dr. Anthony Corrado.