Dorsal or hump reduction could be the right rhinoplasty cosmetic surgery procedure for patients with a nasal bump or hump. A variation of this condition may cause the illusion of a significant nasal bump, called the pseudo-hump or low radix.
The upper bony part of the nose is known as the radix. The radix and underlying cartilage may be significant producing the appearance of a bump. A shallow radix can cause a depression and a bump. The plastic surgeon can reduce the size of the radix by cautiously shaving away small portions.
To add fullness to a depressed area of the nose, the surgeon may use cartilage from another area of the patient’s nose. They can create a straighter slope by augmenting the space right above the radix. The proper management of the radix is important to create a natural nose appearance.
If the patient has a pseudo-hump, it means that the radix is not properly developed and is under-projecting. This creates a facial profile where the tissue underneath the radix, towards the nasal tip, seems even more rotund than it actually is. The appearance of a pseudo-hump occurs when the radix bone does not project the overlying soft tissue properly.
Correcting an Underdeveloped and Low Radix
Rhinoplasty with radix tissue grafting is the most suitable treatment for an under-projecting radix. Cartilage, fascia, or other soft tissue may be used to augment the radix. The graft is usually a sculpted fragment of cartilage, typically taken from the septum. The surgeon places this graft underneath the skin and muscle of the radix.
The surgeon will augment the deficient bony structure by placing a cartilage graft over the bone where it elevates the depressed soft tissue. This procedure helps develop a much straighter profile without the need to remove any cartilage or bone beneath the radix.
Can you have Weak Radix and a True Hump?
Some patients can have an under-developed radix as well as a true hump. The advantage of addressing these problems at the same time is that the surgeon can perform a more conservative hump removal.
The surgeon will bring the ideal profile line closer to the hump by elevating the position of the radix. This will allow the surgeon to create a straighter profile by removing a lesser portion of the hump.
The outcomes of this procedure look less artificial and more natural due to a stronger nasal starting point.
Correcting Radix as Part of Revision Rhinoplasty
The angle between the frontal and nasal bones of the nose forms the height of the radix. This height should be proportionate to the dorsal height, length, and tip for balanced and aesthetically appealing results.
In case the radix remains too high, or the graft placed during the surgery is too large, the nose will have a Romanesque appearance. Revision rhinoplasty involves reducing the radix to its appropriate and most harmonious proportions compared to other nasal aspects and facial characteristics.