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Dorsal Hump
A dorsal hump refers to an excess prominence or bump on the bridge of the nose, which can affect facial aesthetics. This could be hereditary and more prevalent in certain ethnicities. A dorsal hump typically consists of bone, cartilage, or a combination of both, and the surgical approach to its reduction varies depending on its composition.
Considerations
In rhinoplasty, the amount of hump removed is a crucial consideration, as preferences vary widely among individuals regarding the final aesthetic outcome. It is important to discuss whether a small hump should be retained for ethnic or familial features, achieving a straight profile, or a subtle dip. Avoiding an unnatural appearance, such as a "scoopy" or "ski-jump" nose, is typically prioritised unless specifically requested by the patient.
Patients with thicker skin may face additional challenges in achieving significant changes in nasal appearance during hump reduction rhinoplasty. Sometimes, techniques can be employed to encourage the skin to conform around the reshaped nasal structure, enhancing the overall cosmetic outcome.
Before undergoing rhinoplasty, thorough discussions with a surgeon are essential to clarify desired aesthetic goals, often facilitated through image morphing or sketches to visualize potential outcomes.
A pseudo-hump refers to the appearance of a nasal hump caused by a deeply set radix, which is the depression at the upper part of the nose where the forehead transitions into the nasal bridge. In some cases of rhinoplasty, especially in male patients, enhancing the radix area by adding tissue can produce a more aesthetically pleasing result compared to solely removing a lower hump. This approach helps maintain a masculine appearance and prevents the nose from appearing overly small or feminine.
Fix-It
Closed Rhinoplasty
In this technique, the dorsal hump is typically reduced by carefully shaving down the excess bone and cartilage to create a smoother contour.
Open Rhinoplasty
The dorsal hump can be addressed by carefully sculpting the nasal bones and cartilage to achieve a more harmonious profile.
Osteotomy
Regarding changes in breathing after dorsal hump reduction rhinoplasty, an osteotomy is probably necessary to narrow the nose and maintain proportional aesthetics when viewed from the front, although narrowing the nose can potentially restrict airflow. They can be performed during both open and closed rhinoplasty procedures to help reduce and smooth out a dorsal hump. Dr Basheeth uses precision powered instruments – piezoelectric osteotomes. For select patients, latest techniques including preservation rhinoplasty is recommended to achieve aesthetic symmetry and superior profile outcomes.
Grafting
Sometimes, additional cartilage grafts like spreader grafts, lateral crural strut grafts, or modified alar batten grafts may be employed to optimise nasal function while achieving desired cosmetic outcomes. For instance, spreader grafts can be placed along the nasal dorsum to help maintain or increase nasal width after hump reduction. These grafts can also enhance structural support and prevent future collapse.
Suturing Techniques
Strategic sutures may be used to reshape and contour the nasal cartilage and soft tissues, further refining the nasal profile and ensuring symmetrical results.
Turbinoplasty
To address any potential breathing issues post-surgery, an ENT specialist may perform a turbinoplasty procedure to improve airflow and prevent nasal obstruction.
