HUMP REMOVAL

Most humps combine both: bone in the upper part, cartilage from the septum and side walls in the lower. The proportion matters because bone is reduced with rasps or fine chisels while cartilage is trimmed with a blade. Examination and profile photographs estimate each component so reductions blend into one smooth line.

The target is a profile balanced with your features, not maximum reduction. Planning weighs radix depth (the top of the bridge), tip projection, and chin relationship, then reduces toward a straight or very gently curved line. Over-reduction creates a scooped look that is hard to rebuild convincingly, so conservative passes with repeated checking are standard.

Reducing a hump removes the roof where the nasal bones met, leaving a flat "open roof" that reads as wide and feels flat. Most medium or large reductions close it with osteotomies, controlled cuts that let the bones come inward. Small reductions finished with smooth rasping may not need this step.

Only if the roof is not closed properly. An unclosed open roof looks wide and flat, and if the upper side cartilages lose support the middle vault can look pinched or shadowed (an inverted-V deformity). Proper osteotomies, plus spreader grafts or spreader flaps where needed, prevent both problems.

Spreader grafts are small cartilage strips placed alongside the septum. They keep the middle vault open and the dorsal lines smooth. Spreader flaps fold your own side cartilage inward for the same job. Both protect the internal valve (the airway's narrowest point) and reduce the risk of visible irregularity after hump removal.

Profile planning treats the nose as one feature of the face. A deeper radix needs a different bridge line than a high one. A stronger tip can carry a slightly higher bridge. Chin projection changes how prominent any nose looks. Photo or computer simulation aligns these relationships before surgery so the remaining bridge fits your whole profile.

Bridge swelling and early healing callus can mimic a small residual hump for weeks to months. Callus over the bone typically remodels down within 6-12 weeks. A prominence persisting past 3 months is examined to separate swelling, callus, or incomplete reduction.

Causes include rasping marks, uneven callus formation, a graft edge, or simply asymmetric swelling. Most soften with time. Treatment follows the cause: observation for callus, minor in-office options for small edges, and surgical smoothing only after tissues mature. Thin skin reveals more, so it gets extra blending attention during surgery.

Keep pressure off the bridge until the bones knit. Avoid glasses resting on the nose for about 4-6 weeks. Take care with sleeping position. Avoid facial-impact sports for at least 6-8 weeks. If glasses are essential, they can usually be taped to the forehead or supported off the bridge during the protection window.

A removed hump does not regrow. What can appear later is callus at the healing bone edge, a small irregularity previously masked by swelling, or scar tissue. These are smaller and behave differently from the original hump. Most settle with time. A persistent small bony edge can be smoothed by a minor revision after about a year.

Hump removal is mainly a profile change. A straighter bridge can read as slightly different in length, but actual tip position changes little unless tip work is part of the plan. If deprojection or rotation changes are intended, they are discussed as their own decision, not assumed to come free with hump removal.

Over-reduction is rebuilt with onlay grafts, commonly diced cartilage wrapped in fascia (a thin soft-tissue layer) for smaller deficits or rib for larger ones. Irregularity is smoothed or camouflaged with fine grafts once tissues mature, usually after 12 months. Small contour dips can also be masked with filler, which is sometimes the proportionate answer.