Question: I have a hump on my nose that I would like to have removed. Is this done by filing down the hump or by breaking the bones? Can it be performed through closed rhinoplasty?
Answer: If your tip position is perfect then the hump can be removed easily through a closed rhinoplasty. If your tip is over projected or under projected or its rotation angle needs adjustment then this affects the amount of hump requiring removal and the tip should be fixed as well. This too can be done closed but sometimes open rhinoplasty allows more stable long term results.
The composition of the hump may be mostly cartilage or mostly bone or partly each. If the hump is large enough then the bones need to be broken with osteotomy in order to close the gap or “open roof” that results on the top of the nose after hump removal.