Address a Common Concern in the New York Area
What do we mean when we talk about a nasal hump? This has been covered slightly under the category of a large nose. In regards to a nasal hump, our New York area-based team is speaking very specifically about the bridge of the nose, which is made up of nasal bone tissue as well as nasal cartilage tissue. The nasal cartilage in the middle third of the nose consists of the underlying nasal septum, as well as the medial aspect of the upper lateral cartilages.
When patients are seen in a consultation, they usually point to the bridge or bump of their nose and say that this is the area of primary concern that they wish to address. Many patients have other complicating factors in conjunction with the nasal hump, including but not limited to a possible drooping tip, a crooked nose, a deviated nasal septum, a broad nasal tip or an asymmetrical wide nasal tip. These should also be addressed at the same time as addressing the nasal hump.
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The first step in the process is to seek a consultation with an experienced rhinoplasty specialist who will evaluate not only the nasal hump but also the other anatomic variance or structure that is contributing to the poorly balanced nose. This is often communicated very effectively to the patient by using computerized imaging whereby the perspective surgeon can make changes to the patient’s image, profile or frontal view, in an attempt to communicate what they feel would give the patient a desirable and aesthetically pleasing nose. It is very important that the patient is not only able to breathe after surgery, but also will have a nose that is balanced and natural in appearance.
It is Dr. Williams’ opinion that a poorly balanced nose looks considerably larger and, for that reason, the most effective rhinoplasty not only addresses the nasal hump but a structural reorientation where the entire nose is addressed and fixed. This leaves the patient with a nose that fits their face based on sex, height, and ethnicity.
Dr. Williams prefers to use the endonasal/closed approach (more commonly referred to as scarless rhinoplasty) to traditional open rhinoplasty. He feels that this approach is less traumatic than the open approach, which adds significantly more time to recovery.
This and many of the other questions that you may have can be found in the Frequently Asked Questions section of Dr. Williams’ Famous Fireside Chats, where he answers your questions about rhinoplasty.
Nasal Hump FAQs
Where Are the Incisions in Nasal Hump Rhinoplasty?
The location of nasal hump surgery incisions depends on whether an open or closed approach is used. Since there are no incision lines on the exterior of the nose in the closed approach, that technique is referred to as endonasal or scarless nasal hump rhinoplasty.
The advantage of the open approach, according to some surgeons, is the ability to see the nose more completely, allowing for more precision. Many experienced surgeons, including Dr. Williams, prefer the endonasal or closed approach, as it is means less scarring, shorter healing time, and decreased soreness for the patient. Dr. Williams also believes that the closed approach results in more predictable results when it comes to nasal hump surgery.
Some surgeons avoid the endonasal approach due to its complexities, which demand significant experience. In the early years of his surgery, Dr. Williams performed primarily open-approach procedures, giving him a more thorough understanding of the nose and informing his technique to the point where he no almost exclusively performs the closed approach.
Dr. Williams’ Famous Fireside Chats series titled The Great Debate: Open vs. Closed Rhinoplasty gives a more detailed explanation of these two approaches.
Do You Pack the Nose After Nasal Hump Surgery?
While some surgeons still heavily pack the nose after surgery, Dr. Williams feels such packing is overvalued and pointless when performing the procedure with the endonasal or scarless approach he prefers.
In Dr. Williams’ vast experience and contrary to the belief that such packing holds the nose in position after nasal hump surgery, if the surgery is not performed well, heavy packing will do little to hold the nose in position. Also, Dr. Williams avoids the unnecessary discomfort of heavy packing, which is patients’ primary complaint, by using only a small amount of dressing (about the size of a light tampon) to be removed a day after surgery.
Next, about a week after surgery, the outer splint is removed and patients are told to refrain from work or other motions where the nose might be bumped for the next two weeks.
To see Dr. Williams’ dressing and splint removal process, watch his Famous Fireside Chats video on nasal hump surgery.
Will Nasal Hump Surgery Fix Breathing Problems?
During consultation with patients seeking to correct a nasal hump, Dr. Williams often discovers they have difficulty breathing—possibly due to a deviated nasal septum, narrow nasal valves, or a twisted or crooked nose.
Such issues should be properly evaluated by an expert surgeon and, if possible, fixed during cosmetic surgery.
This and other similar questions are the topic of Dr. Williams’ Famous Fireside Chats on correcting and fixing breathing during a procedure.
The Cost of Nasal Hump Surgery
Surgery costs vary based on whether it is a first time or revision procedure, the cost of living where the practice is located, and the experience of the surgeon. Typically, these surgery procedures cost between $7,000 and $14,000.
A second or third surgery requires a seasoned surgeon, as it is more complicated and takes more time. Surgeons with similar skills and experience might cost more in Manhattan versus a small city.
Most importantly, the more experienced a surgeon is, the greater the prospect of achieving the desired results via surgery. This is reflected in the fees.
Refer to Dr. Williams’ Famous Fireside Chats for more information on fees and other considerations regarding nasal hump surgery.
Contact Lenses or Glasses Following Nasal Hump Surgery
After nasal surgery, wearing glasses can be problematic. Dr. Williams advises his patients to fasten some tape on the bridge of their glasses, then hang them from their upper brows.
Patients can resume wearing contact lenses a week or so after nasal hump surgery—once the split or cast is removed.
How is Computerized Imaging Used in Nasal Hump Surgery?
Prior to nasal hump surgery, the patient’s images are captured digitally and modified by the surgeon to reveal the potential outcomes of the rhinoplasty. For almost 25 years, Dr. Williams has relied on this technology to communicate with patients, especially regarding what he sees about the issues and how he will surgically address them.
Dr. Williams’ book Rhinoplasty: Everything You Need to Know about Fixing and Reshaping Your Nose addresses patients’ concerns regarding surgery correcting a nasal hump. Also, check out his YouTube series: Fireside Chats on rhinoplasty procedures.
Complications and Risks of Nasal Hump Rhinoplasty
Complications from surgery correcting a nasal hump are rare, but should be discussed by the surgeon and patient in the consultation phase prior to surgery.
Bleeding or infection are always a concern in any surgery, but are still uncommon after nasal hump surgery. However, there is a possibility that revision or touch-up surgery after this procedure will be required. About five to 10 percent of nasal surgery patients ask for or require a touch-up procedure. It is important to note that such surgeries are less likely to occur when performed by an experienced rhinoplasty surgeon.
If there is a need for a touch-up procedure after nasal hump surgery, it is typically minimal and done in the office, not the OR. Nothing is perfect when it comes to nasal hump surgery. Even a very skilled surgeon must bring all his or her talent, ability, and know-how regarding patient anatomy to the table.
To avoid any misunderstanding or unmet expectations, a careful and deliberate consultation between patient and surgeon should be set up to go over what a successful nasal hump surgery outcome could look like.
More information on potential complications following nasal hump surgery is available on Dr. Williams’ Famous Fireside Chats.
Anesthesia in Nasal Hump Surgery
Patients undergoing rhinoplasty to address a hump will likely have outpatient surgery.
The patient and surgeon will decide what is preferred but, in general, local anesthesia in combination with twilight or general anesthesia is used by an anesthesia provider with the appropriate credentials.
More information on nasal hump surgery can be found in Dr. Williams’ Famous Fireside Chat on Anesthesia for Rhinoplasty.