1101 MADISON ST #1280 SEATTLE, WASHINGTON 98104 | (206) 624-6200
The Facial Plastic Surgery Center
Dr William Portuese - Board Certified Facial Plastic Surgeon

Dorsal hump removal with closed rhinoplasty

Dr. William Portuese performs closed rhinoplasty when patients have a dorsal hump that needs to be removed. Removal of the dorsal hump is the most common reason patients seek out a rhinoplasty procedure. The dorsal hump is composed of 3 structures, which include the cartilaginous upper lateral cartilages, the cartilagenous dorsal portion of the nasal septum, and the nasal bones. These 3 items come together in the nose called the rhinion, which is a growth center for both cartilage and bone. A dorsal hump needs to be shaved down in to be able to remove it successfully. To remove cartilage, this must be cut with a knife or scissors. The bone can be cut with an osteotome, or filed down with a rasp, but it really depends on how large the bony dorsal hump is.

Dorsal hump removal with closed rhinoplasty

Removing the dorsal hump creates a flat-top, open roof nasal deformity. Once the dorsal hump has been removed, both medial and lateral osteotomies of the nasal bones are performed with an osteotome to narrow the nasal bones and close the open roof created from this nasal hump removal. Osteotomies and breaking the nasal bones inward are a necessity for the nose to look good in all 3 dimensions. Once the hump has been removed, some patients do not require any nasal tip work, while others may require the tip to now be balanced with the new bridge line. Minor or major tip adjustments can also be performed during a closed rhinoplasty procedure to make sure the entire structure of the nose balances with itself, and the entire new nose balances with the patient’s complete facial features. Once the hump and osteotomies have been performed, an Aqua-Plast cast is applied across the bridge line of the nose and left in place for 6 days. Patients will get some degree of bruising and swelling lasting approximately 10 days. Full healing is one year after rhinoplasty surgery. All of the incisions for a closed rhinoplasty are placed on the inside of the nose, and the incisions are closed with dissolvable catgut sutures, which fall out in about a week. Dr. William A. Portuese performs dorsal hump reduction rhinoplasty at the Seattle Rhinoplasty Center under general anesthesia as an outpatient surgical procedure. Board certified physician anesthesiologists are in attendance for patient safety and comfort.

A dorsal hump, also known as a bump or convexity on the nasal bridge, can disrupt the balance and harmony of the face. Closed rhinoplasty, a surgical technique performed entirely through internal incisions, offers a highly effective approach to addressing this concern. By utilizing closed rhinoplasty for dorsal hump removal, you can achieve a smoother, more refined nasal contour without external scarring.

Precise Dorsal Hump Reduction:

Closed rhinoplasty allows skilled surgeons to directly access the nasal bridge through internal incisions made within the nostrils. This technique enables them to precisely reshape and reduce the dorsal hump without the need for an external columellar incision. By meticulously sculpting the nasal bone and cartilage, the surgeon can create a smooth and harmonious nasal profile that complements your facial features.

No Visible External Scarring:

A major advantage of closed rhinoplasty for dorsal hump removal is the absence of visible external scarring. All incisions are made inside the nostrils, ensuring that no external sutures or incisions are required. As a result, there are no visible scars on the nasal surface or the columella, allowing for a more discreet and natural-looking outcome.

Shorter Surgical Time and Faster Recovery:

Closed rhinoplasty typically involves less extensive dissection and modification of nasal tissues compared to open rhinoplasty. The reduced surgical time can result in shorter anesthesia duration and potentially faster recovery. Patients often experience less post-operative swelling and minimal nasal trauma. With a quicker healing process, you can expect a faster return to your regular activities and a more comfortable recovery period.

Preservation of Nasal Support:

Closed rhinoplasty allows for the preservation of the nasal support structures during dorsal hump removal. By accessing the nasal bridge through internal incisions, the surgeon can focus on reducing the dorsal hump while maintaining the integrity of the nasal bones and cartilage. Preserving these support structures helps ensure long-term nasal stability and structural integrity.

Personalized and Natural Results:

Closed rhinoplasty for dorsal hump removal offers personalized results that blend seamlessly with your natural facial features. During the consultation, your surgeon will carefully assess your nasal anatomy and discuss your desired outcomes. They will develop a customized surgical plan to address your specific concerns and achieve a balanced and aesthetically pleasing nasal contour that complements your overall facial harmony.

If you are bothered by a dorsal hump, closed rhinoplasty presents an excellent option for achieving a smoother, more refined nasal profile. Consult with a qualified facial plastic surgeon experienced in closed rhinoplasty to discuss your concerns and explore the possibilities. With the expertise and precision of a skilled surgeon, you can achieve a harmonious and natural-looking outcome, enhancing your facial aesthetics and boosting your self-confidence.

Washington Ambulatory Surgery Center Association Washington State Medical Association American Academy of Facial Plastic and Reconstructive Surgery Real Self