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Dorsal Hump Reduction: Understanding the Procedure, Recovery, and Results

The nose plays a central role in defining the balance and harmony of the face. For many individuals, concerns about nasal shape—specifically, a visible bump on the bridge of the nose known as a “dorsal hump”—can be a source of aesthetic concern. Fortunately, modern techniques, like rhinoplasty make it possible to remove or reshape a dorsal hump for a smoother, more balance contour.

In this blog, Dr. Turner, a Sydney-based plastic surgeon, will discuss what causes a dorsal hump, why it forms, and the treatment options available—both surgical and non-surgical—to help you achieve your desired aesthetic goals.

What Is a Dorsal Hump?

Understanding the dorsal hump begins with recognizing the intricate anatomy of the nasal dorsum (bridge). Several key structures come into play:

  • Bony Vault: Composed of the nasal bones, which attach to the frontal bone superiorly and to the nasal process of the maxilla laterally.
  • Upper Lateral Cartilages: Extend beneath the nasal bones and join with the top of the septum. Their position and attachment are vital for maintaining a stable mid-portion of the nose, the “middle vault”.
  • Keystone Area:The Keystone Area is the widest part of the nasal bridge and plays a key role in the nose’s appearance and stability. It is comprised of the nasal bone, cartilaginous septum, bony septum, and upper lateral cartilages.

A dorsal hump is an area of excess bone, cartilage, or both, located along the bridge (dorsum) of the nose. When viewed in profile, this excess tissue creates a noticeable bump that can influence the aesthetics of the nose. In some cases, people with a large dorsal hump may also experience minor breathing or functional issues, although true nasal obstruction often involves additional factors like a deviated septum.

When removing a dorsal hump, the surgeon must navigate these components with precision. Over-resection or improper technique can lead to complications such as an “inverted-V” deformity (which can make the bridge appear pinched) or collapse of the middle vault.

Nasal Anatomy

Causes for a Dorsal Hump

Although a dorsal hump is a noticeable physical feature, its formation can be influenced by multiple factors:

  • Genetics
    Many patients inherit their nasal shape, including a tendency to develop a hump on the bridge. If parents or other family members have a prominent nasal hump, there’s a strong likelihood of passing that trait down through generations.
  • Trauma or Injury
    Nasal fractures, repeated trauma from sports, or accidents can contribute to the development or accentuation of a dorsal hump. When the nasal bones or cartilage are damaged, the healing process can sometimes lead to extra calcification or changes in the nasal structure, thereby creating a dorsal hump that may not have been as pronounced before.
  • Natural Aging
    As we age, our cartilage and soft tissues undergo gradual changes. The supporting structures of the nose may weaken or shift, making a previously subtle hump more apparent over time.

Assessment of Nasal Aesthetics

A thorough consultation is the first step in addressing a dorsal hump. During this process, Dr Turner will examine your nasal anatomy and overall facial structure to identify the areas contributing to the hump.

To help you make an informed decision, Dr. Turner uses advanced 3D imaging technology, such as the Canfield Vectra Software. This software creates a realistic preview of how your nose could look after surgery, allowing you to visualize the results of different modifications. Whether you’re considering a subtle adjustment or a more dramatic change, these visualizations can help clarify how the surgery will enhance your overall facial balance.

In addition to your aesthetic goals, functional considerations are thoroughly addressed. Breathing difficulties or nasal obstructions, such as septal deviations, are evaluated and can be corrected during surgery if necessary. Combining aesthetic enhancements with functional improvements ensures the final result meets your cosmetic aspirations while promoting optimal nasal function.

Non-Surgical Treatment of a Dorsal Hump

Before committing to surgery, some patients explore non-surgical options. One of the most common approaches is the use of cosmetic injectables to camouflage a small dorsal hump. By injecting filler material around the hump, the nasal bridge can appear straighter.

However, Dr. Turner generally advises against using dermal fillers for a dorsal hump, citing several key reasons:

  • Filler Migration: Fillers can move over time, and this migration can create asymmetry or an unnatural appearance.
  • Larger Nose: Adding volume around a hump to minimize its appearance may end up making the entire nose look larger.
  • Complications: The nose has a complex vascular network. Incorrect filler placement can lead to complications like tissue necrosis or, in extremely rare cases, blindness

Rhinoplasty Surgery for Dorsal Hump Reduction

Dorsal hump removal is a common procedure that involves removing excess bone and/or cartilage from the nasal bridge, which can be achieved either through open or closed rhinoplasty surgery

There are two primary surgical approaches for managing a dorsal hump:

Closed Rhinoplasty

Closed Rhinoplasty is often considered for minor dorsal humps and more subtle nasal refinements. In this approach, all incisions are made inside the nostrils, eliminating any external scars. While small bony or cartilaginous irregularities can typically be smoothed using nasal rasps, the limited view of the nasal framework can make more extensive reshaping more challenging.

Open Rhinoplasty

Open Rhinoplasty involves a small incision across the columella (the strip of skin between the nostrils) which continue into each nostril, providing the surgeon with excellent visibility of the nasal structures. This method is especially useful for more complex cases and allows precise shaping of both bone and cartilage.

In modern functional rhinoplasty procedures, a component hump reduction is considered the gold standard approach at treating dorsal hump. This technique is highly effective approach for enhancing aesthetics while preserving nasal function with minimal risk of postoperative complications:

  • Stepwise Approach: Each part of the nasal dorsum—nasal bones, septum and upper lateral cartilages—is treated separately to prevent middle vault complications like an inverted-V deformity.
  • Strength and Stability: By reinforcing structural elements of the nasal dorsum with spreader grafts, the internal nasal valve, further supporting proper airflow and preventing breathing difficulties post-surgery.

Dorsal Hump Reduction - Rhinoplasty

Frequently Asked Questions

Will removing a dorsal hump change my entire facial appearance?
Removing a dorsal hump can enhance your profile and create a smoother nasal bridge, but the goal of modern rhinoplasty is to maintain harmony with your natural facial features. Rather than drastically changing your appearance, the procedure aims to improve facial balance and symmetry, resulting in a more refined yet natural look.

How long does it take to see the final results after rhinoplasty for dorsal hump removal?
You’ll see noticeable changes once the splint is removed, typically one week after surgery. However, residual swelling may take several months to subside. Final results usually become apparent 9–12 months post-surgery, as the nose fully heals and refines its shape.

Can a dorsal hump affect my breathing?
A dorsal hump alone typically doesn’t cause significant breathing issues unless combined with structural problems like a deviated septum. If breathing difficulties are present, these functional concerns can be corrected during rhinoplasty to improve both aesthetics and nasal function.

At what age can I consider rhinoplasty for my dorsal hump?
Rhinoplasty is typically recommended once nasal growth is complete, around 16 for girls and 17 for boys. A consultation with a qualified surgeon is crucial to assess your anatomy, growth stage, and readiness for the procedure.

Will my Medicare or Health Insurance cover rhinoplasty for dorsal hump removal?
Medicare and private health insurance typically don’t cover purely cosmetic rhinoplasty. However, if the procedure addresses functional issues, such as breathing obstructions, partial coverage may be available. Consult your insurance provider for details regarding your specific situation.

What are spreader grafts and why are they important in hump reduction rhinoplasty?
Spreader grafts are small pieces of cartilage placed in the middle vault of the nose to maintain structural support and prevent airway collapse after dorsal hump removal. They also help preserve an ideal nasal bridge width. While modern techniques may reduce the need for spreader grafts in minor cases, they remain essential for ensuring stability and function in more extensive hump corrections.

What Is a Pseudo-Hump?
A pseudo-hump mimics the appearance of a dorsal hump but occurs due to a deep radix, the groove where the nose meets the forehead. This creates the illusion of a hump lower on the nose. Rather than removing tissue, adding filler or tissue grafts to the radix can effectively straighten the nose.

How much hump should I remove?
The amount of hump removal is a highly personal decision in rhinoplasty. Some patients prefer to retain a small hump to preserve ethnic or familial features, while others opt for a completely straight or slightly concave profile. Care is taken to avoid an unnatural “ski-jump” nose unless specifically requested. A detailed consultation with your surgeon, using 3D computer simulations, ensures your goals and preferences are clearly communicated before surgery.

Key Takeaways

  • A dorsal hump is a bump on the nasal bridge caused by excess bone, cartilage, or both.
  • Rhinoplasty offers permanent solutions to improve both aesthetics and nasal function.
  • Alternatives to surgery such as non-surgical rhinoplasty using fillers are available, however results are temporary.
  • Component hump reduction is often the gold standard approach, giving accurate control of the dorsum and stability to minimise nasal obstruction.

Next Steps

If a dorsal hump is negatively impacting your self-image, rhinoplasty offers a permanent way to reshape the nasal bridge. Dr Turner, a Specialist Plastic Surgeon based in Sydney, is experienced in all forms of nasal surgery and can help you determine the best approach for your individual needs.

To learn more about Rhinoplasty Surgery with Dr Turner

  • Schedule a ConsultationContact us at 1300 437758 or visit drturner.com.au to book your appointment.
  • Prepare for Surgery: Follow any preoperative guidelines provided, such as avoiding certain medications and arranging for post-surgery care.
  • Plan for Recovery: Set aside time for rest and healing and arrange for assistance during your initial recovery phase if needed.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult with a qualified healthcare professional to determine the best treatment options for your individual needs. A formal quote will be provided after your consultation with Dr Turner that gives a better estimate of costs involved in your planned procedure.