One of the most common issues that people want to be addressed during their rhinoplasty procedure is the removal of a hump from the bridge. Nasal humps can differ significantly in size.
Some patients have a small bump that they would like refined while others may have more of a Roman nose with a more prominent and distracting hump.
Rhinoplasty cosmetic surgery can reshape the nose regardless of where the nose falls on one of these extremes or somewhere in between. People considering a nose reshaping surgery to reduce a nasal hump should evaluate several things prior to proceeding with the procedure.
How much bridge reduction do you want?
The decision on the level of reduction of the bridge hump is one of individual preferences and aesthetics. Certain individuals prefer a more concave, less protuberant bridge while others seek to maintain a straighter, or slightly full, profile line.
Some patients may desire some bridge fullness post-surgery to maintain some family or ethnic characteristics, or simply as a matter of personal choice. In addition, one must consider the fact that men would want to maintain the masculinity of their nose.
Irrespective of the above, it is vital for the patient to discuss the level of hump reduction that they seek with their surgeon.
The surgeon should be able to undertake in-office digital morphing to simulate the reduction of the hump and offer the patient an idea of how their nose would appear with varying degrees of hump removal.
Pre-operative digital morphing can be a starting point for the discussion between the surgeon and the patient regarding how low the nasal bridge should be. The face and its proportions must be taken into account when deciding this as the bridge must be in harmony with the overall facial framework.
How well will the nasal skin re-drape after bump removal?
Another limitation in terms of hump reduction, or decreasing the overall size of the nose, is that the overlying skin must re-drape over the new, smaller nasal structure. The skin is not removed during the cosmetic surgery. However, the underlying skin elasticity will help it constrict around the new, smaller nose.
Skin re-draping is associated with the problem of how much reduction to make when removing a hump. Patients with thick skin may not be able to achieve the level of nose size reduction that they desire, but some degree of hump removal should still be possible.
If the skin will not be able to properly shrink wrap around the new contours of the nose, the outcomes may be an amorphous blob of skin that would likely worsen the nose appearance.
The surgeon must exercise judgment during the procedure to evaluate how a specific patient’s skin will accommodate this process of shrink wrap effect.
In general, patients with thicker skin as well as younger patients will re-drape quite well while patients with thicker skin and those who are older may not be able to re-drape as vigorously. The risk involved is that the excess skin will create the appearance of a bulbous, ill-defined nose.