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I have a very large bump on my nose that I am planning a rhinoplasty

Question:

I have a very large bump on my nose that I am planning to have removed with rhinoplasty. I always thought the bump was cartilage but I read online that it is made of bone and cartilage. So now I am worried that if you remove the bone, and take off too large of a piece, how can you fix it?

Answer:
To answer your question, first, the hump on a patient’s nose is a combination of bone and cartilage.  The approach that is used with most of our patients is an endonasal approach or a ‘closed’ approach Rhinoplasty.  Using this approach cuts down significantly on the recovery period when the incision is placed on the inside of the nose to visualize the profile using fiber-optics and appropriate exposure.  The approach that we use so that not too much is removed is what I refer to as an ‘incremental hump removal’.  We take down a little bit of the bone and cartilage very slowly.  During the procedure we are constantly assessing the profile so that not too much is removed.  We believe in strong straight profile dorsum as this is a much more natural looking nose and not one where too much bone or cartilage is removed.

There is no way to completely ensure that one has not removed a tiny bit too much; however, this is something that comes with experience and following the patient long-term.  We have performed endonasal Rhinoplasty for almost 20 years and I have taken care of literally thousands of patients for long-term follow-up.  When someone has had too much tissue removed from their profile, the only way to address this is with revision Rhinoplasty, and in our practice we typically use either septal cartilage, conchal cartilage (ear cartilage), or costal cartilage (rib cartilage.)

Revision Rhinoplasty does make up a significant part of our practice and our goal is still the same to leave the patient with a strong straight profile.

Posted by Dr. Williams

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