Reduction of a dorsal hump or nasal hump is perhaps the most common request from patients at The Piazza Center in Austin considering rhinoplasty. Dr. Marcelo Antunes is a rhinoplasty expert who can help improve the appearance and structure of your nose.
Creating a Beautiful Nose
An aesthetically pleasing nasal dorsum can be variable depending on a few things such as ethnicity, sex and other features such as facial and body type. That being said, generally speaking, the ideal nasal dorsum should be a straight line that starts at the level of the upper eyelid and then flows to the nasal tip, on occasion being about 1-2 mm less projected than the tip defining points (most anterior portion of the nasal tip). In other words, if a line was drawn from the nasal tip to the root of the nose, the dorsum will be at or slightly behind that line.
What Is a Dorsal Hump?
The dorsal hump can be caused by an excess bone, cartilage or both. The bridge of the nose is composed of bone in its upper half (or third) and cartilage in the remaining lower half (or two-thirds), depending on how developed the nasal bones are. Some humps are limited to the upper bony portion of the bridge while others are due to excess cartilage. However, the most common scenario is a hump that is composed of both excess bone and cartilage – see the illustration below.
Whichever it is, this can be addressed during rhinoplasty by removing the excess of bone, cartilage or both and bringing the dorsal high to aesthetically pleasing contour.
The degree of how much reduction should be achieved is largely a personal preference.
A Nose to Suit Your Face
Some people prefer a more concave or a slight “scoop” lower bridge whereas others prefer to maintain a straight or even a slightly convex profile view. Taller woman and male patients generally should have a straight (or perhaps a slightly convex bridge in males) while shorter women can sometimes have a slight convexity on their nose and still look good. Regardless of your preference, it is extremely important for you to communicate with Dr. Antunes how much of a hump reduction you want. Dr. Antunes will perform image morphing on your photographs to simulate hump reduction and give you an idea how your nose would look with varying levels of hump removal. Image morphing is a fantastic tool to enhance communication and sets the stage for the discussion between you and Dr Antunes about how low you would like your bridge to be. Click here to learn more about image morphing.
The Pseudo-Dorsal Hump
One important consideration is the presence of a “pseudo-dorsal hump.” This happens when the bony part of the bridge at the root of the nose is underdeveloped and low. This can be present in isolation creating the impression of a hump or can be associated with a nasal hump, accentuating it. If this is present, along with the reduction on the bony and cartilaginous portion of the dorsal hump, you may require a small cartilage graft in the area – this is called radix graft.