San Diego Rhinoplasty – Bump Removal – SKY Facial Plastic Surgery
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SKY Facial Plastic Surgery – Sirius K. Yoo, M.D. –
16918 Dove Canyon Road #208
San Diego, CA 92127
(858) 381-4801
San Diego Rhinoplasty – Nose bump removal and osteotomies
This video explains how a dorsal hump is taken down. It further explains why and how osteotomies are frequently performed to close an open roof. Patients often want to know if they will need their nasal bones “broken” when their bump is removed. The answer depends on the size of the hump to be removed. If there is more than 1-2 millimeters of a bump, then usually the bones will need to be broken. The concept can be illustrated by line art. In this picture of the basal view, the nasal and cheek bones are shown in purple while the cartilaginous septum is shown in gold.
To remove the bump, a conservative amount of both nasal bone and septum must be excised. This is illustrated with the burnt orange line. Comparing the first and second line drawings, the height of the nose has been reduced. There is now a gap between the nasal bones and the septum. The gap is called an “open roof”. The overlying skin contour is now shown in orange. As you can see, an open roof leads to a nose that appears wide and flat.
To correct this, the nasal bones must be repositioned by making cuts through the junction of the nasal and cheek bones. The technical term for these cuts are osteotomies and are once again shown by the burnt orange lines. Osteotomies are the maneuver that patients are referring to when they think of the nose being broken. Now the nasal bones can be rotated back to meet the septum and close the open roof. Alternatively, if someone has a wide nose as well as a dorsal hump, this can be corrected by moving the nasal bones medially rather than rotating them. This may leave a small gap between the cheek bones and nasal bones highlighted in light purple. This small gap will heal and fill in without any loss of structural integrity.
I hope you have a better understanding of how a dorsal hump is addressed in rhinoplasty and why osteotomies are frequently necessary to produce better results. For more educational information on rhinoplasty as well as before and after photos from SKY Facial Plastic Surgery, please visit us at
