American Society of Plastic Surgeons
For Medical Professionals
3 years ago

Can a dorsal hump be shaved down without an osteotomy?

The only issue with my nose is a dorsal hump that gives me an ugly profile. If this is the only thing I want fixed since I don't have breathing problems with my nose can this be achieved by just shaving the hump down? Also, could this be achieved through closed rhinoplasty?

Procedure: Rhinoplasty
Location: Hastings on Hudson, NY

Replies 6

Steven Wallach
ASPS Surgeon

While the jump can be shaved down, it may lead to a very flat look or an open roof if osteotomies are not performed.

Richard Greco
ASPS Surgeon
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Excellent questions. You should visit a board certified plastic surgeon and he can review your history and exam you. They can go ovr the list of risks and complications.

The risks of General anesthesia are very rare, and not much different than having anesthesia for any operation.

One can take the hump through a closed rhinoplasty for sure. The reason to break the nose would be to prevent having an "open roof" deformity - or a flat dorsum. This would be part of the discussions.

Norman Bakshandeh
ASPS Surgeon

Rhinoplasty can be done with an open or closed technique. Shaving down a dorsal hump especially if it is very high leaves you with a open roof which does not look good. Small dorsal humps can be rasped and dont need osteotomies if the nose is not wide. I do my osteotomies with a tiny 2mm. chisel. There is minimal swelling and it really improves the results

Adolfo Sesto
ASPS Int. Surgeon

Hello Hopeful. Without pictures of your nose is impossible to give you any opinion on how it can be corrected.

Francis Collini
ASPS Surgeon

the answer to your questions are as follows: yes, the shave down can be done without an osteotomy and yes, it can be achieved with a closed rhinoplasty. That said, you must bear in mind that if the hump is excessive (only a Board certified plastic surgeon can make that judgment), without an osteotomy, your nose may look excessively wide after the hump is shaved off. Honestly, in my opinion, it is best to do it with the osteotomy - it only takes minutes to do it, the risk is small and the cosmetic benefits far outweigh not doing it. 30 years of rhinoplasty and I have done an osteotomy in over 99%. Trust your instincts but do not let fear take you down a dead end road.

Karen Leong
ASPS Surgeon

Hello! It depends on whether your hump is bony or cartilaginous or both. Often times, if you only shave down without corresponding osteotomies, your bridge can look wider than before and there is a risk of an open roof deformity (imagine a pitched roof to a house that you cut the top off!). Osteotomies bring the nasal bones back together. - Dr. Leong


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