Dorsal Hump: Causes, Surgery, Recovery, and Removal Cost

nose job

What is a dorsal hump?

A dorsal hump is a visible “bump” on the bridge of the nose. This bump is usually most noticeable in a profile view but less apparent when viewed from the front.

Dorsal humps are made of cartilage or bone – around two thirds are composed of cartilage and about one third are bone. If the hump is in the upper part of your nasal bridge, it’s more likely to be bony in nature. If located in the lower region, then it’s typically composed of cartilage. Dorsal humps can also be composed of both cartilage and bone.

What causes a dorsal hump?

A bump on the nose bridge can occasionally arise from trauma or injury. More commonly, it’s genetic or an inherited trait. You might have other family members who have similar bumps on their noses.

If you do have a history of trauma to the nose, let your plastic surgeon know as it can impact the choice of procedure used to correct the problem.

How dorsal hump surgery is performed

A plastic surgeon can alter the appearance of a dorsal hump through a procedure known as reduction rhinoplasty. First, your surgeon will evaluate the hump and determine whether it’s made of cartilage, bone, or both. The composition of the hump, its location, and how large it is can impact the chosen surgical approach.

If the dorsal hump is mostly made of bone, the excess bone can be surgically removed so the bump is less apparent, giving the nasal bridge a straighter contour. If it’s composed of cartilage, the surgeon will trim away the excess cartilage so the bridge of the nose forms a smooth line, reducing this fullness.

The excess skin resulting from the removal of the bump drapes itself over the new nasal bridge in the following weeks or months, depending on how much cartilage or bone was taken out. In some cases, the plastic surgeon may be limited in how much can be removed. If you have thick skin and too much bone or cartilage is taken away, re-draping may give an end result that’s not aesthetically pleasing.

You might also prefer to limit the amount of work done to stay true to your ethnic heritage, or because you don’t want too drastic a change. Discuss these issues with your plastic surgeon beforehand so that the final look meets your expectations.

Open vs. closed rhinoplasty

If the hump is small to moderate in size, your plastic surgeon may perform a closed rhinoplasty, during which the dorsal hump is accessed through the nasal passages and the incisions are made inside the nostrils.

If the hump is larger and requires more tissue removal, the surgeon may instead choose to do an open rhinoplasty. With this approach, an incision is made along the columella, the narrow strip of tissue between the nostrils. This allows for a better visualization of the area. Your surgeon may also use a spreader graft composed of cartilage to help widen the airway and make breathing easier.

Recovery and results

How quickly you recover from surgery depends partially on the approach the surgeon used. If a closed rhinoplasty was performed, the area may heal more quickly.

With either approach (closed or open), you’ll experience swelling after the procedure. However, swelling is less pronounced and usually resolves faster with a closed rhinoplasty. The swelling will typically last a few weeks and will vary with how much tissue was removed and how much repositioning was done.

Right after the surgery, you will likely experience stuffiness, congestion and perhaps pain, which can be relieved using pain medications. You’ll also have packing in your nose. Usually, the packing is removed on the second day but be prepared as it may have to stay in longer.

By the end of the first week, you’ll likely have your splint off and the swelling and bruising will be less pronounced. You will most probably be ready to return to work, although you will need to avoid strenuous activities and sun exposure. These are general guidelines and may vary depending on your particular situation.

Your healing will progress as the weeks go by and you’ll finally get the first glimpse of what your new nose will look. Your surgeon will usually give you the okay to exercise again after three to four weeks.

Healing will continue for months as the swelling subsides and the final result becomes more visible, but it can take a year or more for the scars to lighten and fade.

It’s hard to give specifics as each person heals at their own rate. Factors that impact healing include health status – for example, people with diabetes typically have a slower healing rate. Age and how well you care for the surgical site can also speed up or delay healing.

Is reduction rhinoplasty safe?

Every surgery comes with risks. These include reactions to the anesthesia, the possibility of the area becoming infected, and the potential for poor wound healing or scarring.

Visible scarring is more common with an open rhinoplasty, although any scarring that occurs is usually slight and barely visible as it’s on the underside of the nose. Some people, especially those with darker skin tones, can form thicker, more obvious scars.

Less commonly, the nerves in the area can get damaged, causing numbness or pain. You can also experience problems breathing after the surgery. Also less typically, the nasal septum – the tissue that separates the two sides of the nose – can get damaged or perforated. Sometimes, blood or fluid collects under the skin after surgery and may require drainage or removal. Rarely, a nasal structure may be permanently damaged.

The risk of complications is higher with an open rhinoplasty as opposed to a closed one. Naturally, risks are lower when you’re under the care of a surgeon who is experienced with the procedure.

What is the removal cost of a dorsal hump?

Whether your surgeon decides to perform open or closed rhinoplasty to fix your dorsal hump, you should expect to pay $6,000-$8,000.

Non-surgical alternatives

If you have a small nasal bump, an injection with filler above and below the hump may make it less apparent. Note that injecting some areas of the nose, such as the tip, carries a higher risk of complications. In addition, most fillers eventually dissolve and the injections must be repeated, so this isn’t a permanent solution.

Another drawback to nose filler injections is the risk of lumpiness, which can happen if the filler is injected too close to the skin instead of deeper in the tissue. This can be corrected by injecting a product that dissolves the filler.

Additionally, if the filler is placed too superficially, the skin around the injection may take on a bluish discoloration, known as the Tyndall effect. There’s also a small risk of infection at the site, numbness, or an allergic-type reaction to the filler.

How to choose the best option

If you’re considering a surgical procedure, it’s important to ask questions and get answers. A plastic surgeon should sit down with you and determine what can be achieve and the options available to you. Together, you can come up with a plan that addresses your needs and helps you sculpt the nose that best enhances your face.

» If you’re looking for a rhinoplasty expert, meet our medical review team to get answers to all your preliminary questions.

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