eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Cosmetic Surgery

Rhinoplasty, Nasal Hump: Follow-up

Author: Elizabeth Whitaker, MD, Clinical Assistant Professor, Department of Otolaryngology, Division of Facial Plastic Surgery, Atlanta Surgical Group, PC
Contributor Information and Disclosures

Updated: Nov 18, 2008

Outcome and Prognosis

Dorsal hump resection can be a very satisfying operation for both patient and surgeon. Conservative resection of bone and cartilage can translate into a significant effect on nasal contour and character. In patients with very large humps, results may be limited by the ability of the skin–soft tissue envelope to redrape over a significant skeletal reduction. Overall, most patients are satisfied with the outcome of rhinoplasty surgery, and revision rates are low.

For excellent patient education resources, visit eMedicine's Breaks, Fractures, and Dislocations Center. Also, see eMedicine's patient education article, Broken Nose.

Future and Controversies

Although the general principles and techniques of dorsal hump reduction remain essentially the same, instrumentation has continually evolved. In recent years, powered instrumentation for the nasal dorsum has become available. Proponents of this technology note the advantages of increased precision and less soft tissue trauma. Traditional instruments such as rasps and osteotomes, particularly in experienced hands, accomplish the same end and remain the standard of care. However, powered instrumentation may have an advantage in challenging areas such as the nasofrontal angle.

 


More on Rhinoplasty, Nasal Hump

Overview: Rhinoplasty, Nasal Hump
Workup: Rhinoplasty, Nasal Hump
Treatment: Rhinoplasty, Nasal Hump
Follow-up: Rhinoplasty, Nasal Hump
Multimedia: Rhinoplasty, Nasal Hump
References

References

  1. Guyuron B. Nasal osteotomy and airway changes. Plast Reconstr Surg. Sep 1998;102(3):856-60; discussion 861-3. [Medline].

  2. Vermeiren J, De Vos G. The feather touch rasp, a powered instrument for hump reduction. B-ENT. 2007;3(3):113-7. [Medline].

  3. Adamson PA. The over-resected nasal dorsum. Facial Plast Surg Clin North Am. Nov 1995;3(4):407-419.

  4. Adamson PA, Galli SK. Rhinoplasty approaches: current state of the art. Arch Facial Plast Surg. Jan-Feb 2005;7(1):32-7. [Medline].

  5. Anderson JR, Ries WR. Rhinoplasty. In: Emphasizing the External Approach. NY: Thieme Medical Publishers; 1987.

  6. Arslan E, Aksoy A. Upper lateral cartilage-sparing component dorsal hump reduction in primary rhinoplasty. Laryngoscope. Jun 2007;117(6):990-6. [Medline].

  7. Becker DG, Toriumi DM, Gross CW, et al. Powered instrumentation for dorsal reduction. Facial Plast Surg. Oct 1997;13(4):291-7. [Medline].

  8. Gunter JP, Rohrich RJ, Adams WP. Component Osseocartilaginous Hump Reduction: A Graduated Approach to the Dorsum. Dallas Rhinoplasty. 2002;1:471-499.

  9. Hall JA, Peters MD, Hilger PA. Modification of the Skoog dorsal reduction for preservation of the middle nasal vault. Arch Facial Plast Surg. Mar-Apr 2004;6(2):105-10. [Medline].

  10. Harris MO, Baker SR. Management of the wide nasal dorsum. Arch Facial Plast Surg. Jan-Feb 2004;6(1):41-8. [Medline].

  11. Johnson CM Jr, Toriumi DM. Open Structure Rhinoplasty. Philadephia: WB Saunders Co; 1990.

  12. Johnson,CM Jr, To, WC. '. A Case Approach to Open Structure Rhinoplasty. 2005.

  13. Kim YD, Danchek M, Myers AK, et al. Anaesthetic modification of regional myocardial functional adjustments during myocardial ischaemia: halothane vs fentanyl. Br J Anaesth. Mar 1992;68(3):286-92. [Medline].

  14. Larrabee WF. Open rhinoplasty and the upper third of the nose. Facial Plast Surg Clin North Am. Aug 1993;1(1):23-38.

  15. Lupo G. The history of aesthetic rhinoplasty: special emphasis on the saddle nose. Aesthetic Plast Surg. Sep-Oct 1997;21(5):309-27. [Medline].

  16. McCollough EG, Maloney BP. Reduction of the nasal dorsum. Facial Plast Surg Clin North Am. Nov 1994;2(4):425-434.

  17. McKinney P, Johnson P, Walloch J. Anatomy of the nasal hump. Plast Reconstr Surg. Mar 1986;77(3):404-5. [Medline].

  18. Murakami CS, Larrabee WF. Comparison of osteotomy techniques in the treatment of nasal fractures. Facial Plast Surg. Oct 1992;8(4):209-19. [Medline].

  19. Natvig P, Sether LA, Gingrass RP, et al. Anatomical details of the osseous-cartilaginous framework of the nose. Plast Reconstr Surg. Dec 1971;48(6):528-32. [Medline].

  20. Parkes ML, Kanodia R. Avulsion of the upper lateral cartilage: etiology, diagnosis, surgical anatomy and management. Laryngoscope. May 1981;91(5):758-64. [Medline].

  21. Sheen JH, Sheen AP. Aesthetic Rhinoplasty. Quality Medical Publishing Inc: 1998.

  22. Skoog T. A method of hump reduction in rhinoplasty. A technique for preservation of the nasal roof. Arch Otolaryngol. 1966;83(3):283-7. [Medline].

  23. Straatsma BR, Straatsma CR. The anatomical relationship of the lateral nasal cartilage to the nasal bone and the cartilaginous nasal septum. Plast reconstr surg (1946). Dec 1951;8(6):433-55. [Medline].

  24. Stucker FJ, Smith TE Jr. The nasal bony dorsum and cartilaginous vault. Pitfalls in management. Arch Otolaryngol. Nov 1976;102(11):695-8. [Medline].

  25. Tardy ME Jr. Rhinoplasty: The Art and the Science. WB Saunders Co; 1997.

  26. Tardy ME Jr, Brown RJ. Surgical Anatomy of the Nose. Raven Press; 1990.

  27. Toriumi DM, Hecht DA. Skeletal modifications in rhinoplasty. Facial Plast Surg Clin North Am. Nov 2000;8(4):413-432.

  28. Verwoerd CD, Verwoerd-Verhoef HL. Developmental aspects of the deviated nose. Facial Plast Surg. Winter 1989;6(2):95-100. [Medline].

  29. Webster RC, Davidson TM, Smith RC. Curved lateral osteotomy for airway protection in rhinoplasty. Arch Otolaryngol. Aug 1977;103(8):454-8. [Medline].

  30. Whitaker EG, Johnson CM Jr. The Evolution of Open Structure Rhinoplasty. Arch Facial Plast Surg. 2003;5:291-300.

  31. Wright WK. Lateral osteotomy in rhinoplasty. Further considerations. Arch Otolaryngol. Nov 1963;78:680-5. [Medline].

  32. Wright WK. Surgery of the bony and cartilaginous dorsum. Otolaryngol Clin North Am. Oct 1975;8(3):575-98. [Medline].

Further Reading

Keywords

rhinoplasty, nasal hump rhinoplasty, dorsal hump reduction, nasal hump reduction, dorsal profile, aesthetic rhinoplasty, dorsal hump excision, dorsal hump resection, dorsal hump, dorsal nasal prominence, open roof deformity, osteotomy, lateral osteotomy, low-low osteotomy, low-high osteotomy, high-low-high osteotomy, curved osteotomy, greenstick fracture, open roof deformity, stair-step deformity, rocker deformity, saddle-nose deformity, polly beak deformity, nose job, nasal surgery, rhinoplasty, nasal hump, nasal bump, nose surgery

Contributor Information and Disclosures

Author

Elizabeth Whitaker, MD, Clinical Assistant Professor, Department of Otolaryngology, Division of Facial Plastic Surgery, Atlanta Surgical Group, PC
Elizabeth Whitaker, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

S Valentine Fernandes, MBBS, MB, BS, BSc(Hons), MCPS, FRCSEd, FRACS, FACS, Conjoint Senior Clinical Lecturer, Department of Otorhinolaryngology, Newcastle University; Senior Consultant Surgeon, Department of Otorhinolaryngology-Head and Neck Surgery, John Hunter, Toronto Private and Kurri Hospitals, Australia
S Valentine Fernandes, MBBS, MB, BS, BSc(Hons), MCPS, FRCSEd, FRACS, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American College of Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Dean Toriumi, MD, Department of Otolaryngology, Associate Professor, University of Illinois Medical Center
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.