Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney
A dorsal hump is a bump on the nasal bridge caused by excess bone, cartilage, or both. It’s one of the most common concerns patients raise at rhinoplasty consultations — often something they’ve been self-conscious about for years — and it’s also one of the areas where rhinoplasty can produce the clearest, most visible change in profile.
Dr Scott J Turner is a Fellow of the Royal Australasian College of Surgeons (FRACS) with specific training in rhinoplasty, including both component hump reduction and preservation rhinoplasty techniques. He consults at his Sydney clinics in Bondi Junction and Manly, with surgery performed at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why.
What Is a Dorsal Hump?
The nasal bridge (dorsum) is made up of several structures: the nasal bones in the upper third, the upper lateral cartilages in the middle third, and the cartilaginous septum running through the centre. A dorsal hump occurs when there is excess tissue at the junction of these elements, creating a raised profile that is visible from the side.
The composition of a hump varies. Some are predominantly bony and sit higher on the bridge. Others are predominantly cartilaginous and sit in the mid-vault. Many involve both. The composition affects which surgical technique is most appropriate.
A hump that appears significant in profile may be partly explained by a low nasal radix — the area between the eyes at the top of the nose. A low radix can make a modest hump appear more prominent. In these cases, augmenting the radix rather than aggressively reducing the hump can produce a more balanced result with less tissue removal.
What Causes a Dorsal Hump?
In most patients, a dorsal hump is simply a structural feature — an inherited nasal anatomy, often familiar in other family members. It can also develop or become more prominent after nasal trauma, where the bones or cartilage heal in a raised position. And occasionally, a hump that wasn’t troubling in youth becomes more noticeable as other facial features change with age.
Surgical Techniques for Hump Reduction
Component Hump Reduction
Component hump reduction is the standard approach for most dorsal hump cases. Rather than treating the hump as a single structure, this technique addresses the bony and cartilaginous elements separately — the nasal bones, upper lateral cartilages, and septum are each modified in a stepwise sequence to accurately control the final dorsal height and shape.
After the dorsal tissue is lowered, the nasal bones are repositioned inward with controlled osteotomies (bone cuts) to close the resulting gap and narrow the bony width. Spreader grafts — small cartilage pieces placed in the mid-vault — are typically used to maintain structural support and prevent internal valve compromise following reduction.
This approach gives precise control over the final profile and is appropriate for moderate to significant humps.
Preservation Rhinoplasty
Preservation rhinoplasty takes a different approach. Rather than removing tissue from the dorsum, the hump is lowered by displacing the whole nasal bridge downward — a “let-down” manoeuvre that maintains the natural contour of the dorsum without removing it.
This technique suits patients with a modest hump where subtle change is the goal. It avoids the open-roof deformity that can occur with component reduction and tends to produce less post-operative swelling. It is not appropriate for all hump types — the anatomy and degree of change required determine whether it is applicable.
For more details on this approach, see preservation rhinoplasty.
Ultrasonic (Piezoelectric) Rhinoplasty
Ultrasonic rhinoplasty uses piezoelectric instruments to reshape nasal bone using ultrasonic vibration rather than traditional cutting tools. The advantage is greater precision when working on bone, with less trauma to surrounding soft tissue. Dr Turner uses this technique for selected cases where precise bone contouring is needed. It is an approach to bone management within rhinoplasty, not a standalone procedure.
How Much of the Hump Should Be Removed?
This is one of the most important conversations at the consultation, and the answer is genuinely personal. Patients vary considerably in how much change they want and what looks right for their face.
Some prefer a completely straight profile. Others want a modest reduction that softens the hump while retaining some of the character of their nose, particularly in patients of Middle Eastern or Southern European backgrounds, where a degree of bridge prominence is a normal and culturally significant feature. Removing too much can produce an over-scooped or upturned result that looks operated.
Dr Turner uses Vectra 3D imaging during consultation to assist in visualising different degrees of reduction, so patients can select a goal that feels right for their face before surgery.
One important consideration: over-resection of the dorsum is not easily corrected. It is among the more common reasons for revision rhinoplasty. Conservative reduction that preserves the natural character of the nose ages better and is more consistent with the face around it than aggressive removal.
Is There a Non-Surgical Option?
Non-surgical rhinoplasty using dermal filler can add volume to the areas above and below a hump to visually smooth the bridge profile. It can make a modest hump appear less prominent. It does not remove the hump. Results are temporary and need to be repeated. For patients who want to reduce an obvious hump, filler is not a substitute for surgery.
Who Is a Suitable Candidate?
Dorsal hump reduction may be appropriate if you:
- Have a specific concern about a visible bump on the nasal bridge
- Have realistic expectations about the degree of change surgery may achieve
- Are in good general health with no conditions that significantly increase surgical risk
- Are a non-smoker, or can cease smoking well before surgery
- Have fully developed nasal anatomy — typically from mid-to-late teens onwards
Where the hump is accompanied by a functional concern — a deviated septum or breathing problem — combining the cosmetic and functional work in a single septorhinoplasty is generally the recommended approach.
Recovery
Recovery follows the standard rhinoplasty timeline. A nasal splint is worn for approximately one week. Visible bruising and swelling resolve over two to three weeks. Most patients are comfortable in public settings by two to three weeks and return to desk-based work during this period.
The final result — with the full profile visible and all residual swelling resolved — is seen at nine to twelve months. The bridge profile is typically visible much earlier, from splint removal at one week, though with swelling still present. Patients are usually pleased with the early result and find that continued improvement over the following months is a welcome process.
For a full week-by-week breakdown, see the rhinoplasty recovery guide.
Cost
Dorsal hump reduction is priced within the cosmetic rhinoplasty range at Dr Turner’s practice. All figures are all-inclusive: surgeon, hospital, anaesthesia, and all follow-up visits.
| Procedure | All-inclusive cost |
|---|---|
| Cosmetic rhinoplasty | $18,000–$26,000 |
| Consultation | $450 |
A formal itemised quote is provided after consultation. For full pricing details, see the rhinoplasty cost guide.
AHPRA Regulatory Requirements
Under AHPRA cosmetic surgery guidelines (effective 1 July 2023), the following apply before dorsal hump reduction rhinoplasty can proceed:
- A referral from your GP or a specialist physician
- A minimum of two consultations with Dr Turner before surgery is booked
- A psychological evaluation to confirm suitability
- A mandatory cooling-off period before formal consent is given
Frequently Asked Questions
What is dorsal hump reduction rhinoplasty?
Dorsal hump reduction is rhinoplasty surgery to reduce or remove a bump on the nasal bridge. The hump may be composed of cartilage, bone, or both. Surgical approaches include component reduction, where the cartilaginous and bony elements are addressed separately to precisely control the dorsal height, and preservation rhinoplasty, where the hump is lowered by moving the dorsum downward rather than removing tissue from it. The right approach depends on the nature of the hump and the patient’s anatomy, and is discussed at consultation.
How much of the hump can be removed?
The degree of reduction that is appropriate depends on individual anatomy, facial proportions, and how much change looks right for the patient’s face. Some patients want a completely straight profile; others prefer a modest reduction that softens the hump while preserving some character. Over-reduction — removing too much — can produce an operated or upturned result that is difficult to correct. Dr Turner uses 3D imaging at consultation to help patients visualise different degrees of reduction before deciding.
What is a pseudo-hump?
A pseudo-hump is an appearance of a dorsal hump caused by a low or underdeveloped nasal radix — the depression between the eyes at the top of the nose. The low radix creates the illusion of a hump further down the bridge. Correction involves augmenting the radix with a small cartilage graft rather than reducing the bridge, which preserves tissue and produces a more balanced result. Identifying whether a hump is genuine or pseudo is part of the consultation assessment.
What are spreader grafts and why are they used in hump reduction?
Spreader grafts are small pieces of cartilage placed in the mid-vault of the nose following dorsal reduction to maintain structural support and prevent collapse of the internal nasal valve. After the hump is reduced, the gap between the upper lateral cartilages and the septum may need structural reinforcement. Spreader grafts provide this support and help maintain both the nasal profile and airway function. They are standard in moderate to significant hump reduction rhinoplasty.
When will I see the final result after dorsal hump reduction?
The nasal splint is removed at approximately one week, and the new bridge profile becomes visible — though with significant swelling still present at this stage. Most obvious swelling resolves over two to three months. The final result, with all residual swelling resolved, is seen at nine to twelve months. Individual healing timelines vary. Patients with thicker nasal skin may take longer.
Consult with Dr Scott J Turner
Dr Turner consults for dorsal hump reduction rhinoplasty in Sydney at Bondi Junction and Manly. He also sees patients in Brisbane, Canberra, Newcastle, and the Gold Coast. Surgery is performed in Sydney at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why.
Contact the practice to arrange a consultation, or read more about Dr Turner’s background and training.
