Removing a Dorsal Hump with Rhinoplasty Surgery

A dorsal hump can throw off the balance of the face, especially in profile. Rhinoplasty is the standard way to remove one and give the face a more balanced profile.

What is a Dorsal Hump?

A dorsal hump is a raised bump along the bridge of the nose, formed by the nasal bones and the septum. It is also called a nasal hump or dorsal bump. Some people like the character it gives their nose; others feel it throws off their profile.

How to get rid of the dorsal hump?

A dorsal hump is removed with cosmetic rhinoplasty. The surgeon takes down the excess bone and cartilage that form the hump, then shapes the bridge so it is straight and in proportion with the rest of the nose. Cartilage grafts are sometimes used to refine the shape further. Swelling and bruising settle over a few weeks. The straighter profile shows once the cast comes off, but the final result takes several months to appear as the swelling resolves.

Benefits of Removing a Dorsal Hump with Rhinoplasty Surgery

The main benefit of removing a dorsal hump is cosmetic. By reshaping the nasal bones and cartilage, the surgeon lowers the bridge (the nasal dorsum) so the nose sits in better balance with the rest of the face.

Removing the hump can also make the nose look smoother and more symmetrical.

Rhinoplasty is precise work. During surgery, the nasal septum and internal nasal valve are reshaped as the hump is lowered, and when breathing is already compromised, this work can help the nose function better as well. The goal is a straighter profile and better facial balance and harmony.

Preparing for Rhinoplasty Surgery to Remove a Dorsal Hump

Good preparation helps the surgery go smoothly and lowers the risk of complications.

Start with a consultation with a facial plastic surgeon who specializes in rhinoplasty. Use the consultation to ask questions until you understand what the surgery involves and what result to expect. Then follow your pre-surgery instructions and keep your pre-operative appointments.

Plan ahead for recovery. Swelling and bruising are significant at first, and most patients need about a week off work. You’ll likely be prescribed antibiotics as part of your recovery time, as well as medications to help manage any pain or discomfort during the days immediately following your procedure. Talk with your surgeon about any activities that should be avoided during your recovery period.

The Procedure for Removing a Dorsal Hump with Rhinoplasty Surgery

The steps are fairly consistent. First, the surgeon makes the incisions, either inside the nostrils (closed rhinoplasty) or with an added small incision across the columella, the strip of skin between the nostrils (open rhinoplasty). Then the excess bone and cartilage are removed and the bridge is shaped.

Next, sutures are used to sculpt and refine the shape of the nose so that it aligns with facial features. The surgeon may also use cartilage grafts to provide a support structure and additional definition if required. Finally, the incisions are closed and a splint (cast) is placed on the nose, where it usually stays for 5 to 10 days.

Surgery usually takes about two hours, and longer if other procedures such as septoplasty or turbinate reduction are being performed at the same time. After surgery has been completed, patients should expect some swelling and bruising, but these should subside within a couple of weeks as recovery continues.

Closed rhinoplasty technique

In a closed rhinoplasty, all of the incisions are inside the nostrils. Working through them, the surgeon lowers the nasal dorsum and reshapes the nasal bones and lateral cartilages.

Some patients prefer the closed technique because there is no external incision and so no visible scar. The open technique, described below, gives the surgeon a more direct view when more extensive reshaping is needed.

As with any rhinoplasty, sutures and, when needed, cartilage grafts are used to refine the shape and support the bridge.

Open rhinoplasty technique

In an open rhinoplasty, the surgeon adds a small incision across the columella, the strip of skin between the nostrils. This allows the skin to be lifted so the nasal bones, lateral cartilages and dorsum can be reshaped under direct view.

Because the surgeon can see and reach every part of the nasal framework, the open approach allows more precise sculpting, and it is the usual approach for revision rhinoplasty.

The incisions are then closed with sutures or skin glue before the cast goes on.

Aftercare and Recovery Following Rhinoplasty Surgery to Remove a Dorsal Hump

How you care for your nose after surgery affects the result. Expect swelling, bruising and some discomfort for the first few weeks; you will have medication to manage the pain.

Keep your head elevated for about a week after surgery, and use an ice pack to reduce swelling around the nose. Avoid exercise and heavy lifting for about a month, and wear sunglasses outdoors to protect your eyes from bright sunlight.

You may also be told to avoid hot showers for the first few days. Following these instructions and keeping your follow-up appointments gives you the best chance of healing without complications.

Potential Risks and Complications of Removing a Dorsal Hump with Rhinoplasty Surgery

Although nose surgery is generally safe, it carries the same kinds of risks as any cosmetic surgery. Risks to understand before having a dorsal hump removed include:

• Taking down or narrowing the bridge too much can leave an unnatural-looking nose that may need revision surgery.
• Infection may require antibiotics or even surgical repair if not addressed in time.
• Swelling and bruising can last for weeks after the surgery. In rare cases, this can cause breathing difficulties.

Contact us Today!

Every surgery carries some risk, but careful planning and following your aftercare instructions keep it low. Contact us to talk about your goals and whether removing the hump is the right choice for you.

Dr. Shervin Naderi is a double board-certified facial plastic surgeon and rhinoplasty specialist with more than 20 years of experience. He performs both surgical rhinoplasty and liquid rhinoplasty (nonsurgical rhinoplasty using dermal fillers), so he can tell you honestly which approach will give you the result you want.

Frequently Asked Questions

Can a dorsal hump be removed without surgery?

No. A liquid rhinoplasty with filler can make a small hump less noticeable by smoothing the line of the bridge, but it cannot remove the hump or make the nose smaller. Taking the hump down requires surgical rhinoplasty.

How long does dorsal hump removal surgery take?

Rhinoplasty to remove a dorsal hump usually takes about two hours under general anesthesia. It takes longer if septum or turbinate work is done at the same time.

What is recovery like after dorsal hump removal?

The cast stays on for 5 to 10 days, and most patients need about a week off work. Bruising and swelling settle over the first few weeks, exercise waits about a month, and the final shape takes several months to show.

Will removing a dorsal hump leave a scar?

A closed rhinoplasty uses incisions inside the nostrils, so there is no visible scar. An open rhinoplasty adds a small incision across the columella, the strip of skin between the nostrils.

Can a deviated septum be fixed at the same time as hump removal?

Yes. Septum or turbinate work can be done during the same operation, which adds some time to the surgery.