Dorsal Hump Corrections
A dorsal hump or "hump" as patients commonly refer to it, is a convex shape to the bridge of the nose. The hump, by deviating from the classic straight bridge profile, draws attention to the nose. Thus, even if a nose is otherwise small (as far as length or tip size) it still seems large and out of proportion. In women, a prominent hump can be masculinizing and especially bothersome to the patient.
Dorsal hump is one of the most common complaints for patients seeking rhinoplasty surgery, and “hump removal” or profile sculpting is one of the most common components in rhinoplasty surgery. Achieving a great outcome in hump removal requires an appreciation for the ideal bridge contour. Generally, the starting point for the nose on profile view should be a point on level with the upper eyelid crease. From here, the bridge should extend downward in a straight line to the tip of the nose.
Supratip break can be an attractive feature, especially in the female nose. This means that the tip of the nose projects slightly past the straight line of the bridge. Achieving this balance between bridge and tip height can be the most challenging part of profile alignment.
Creation of an ideal bridge following hump removal requires meticulous sculpting of cartilage and bone, but also an appreciation for the healing process. Even if the rhinoplasty surgeon is able to sculpt an ideal bridge "on the table," as swelling and wound contracture set in, the body may deposit scar tissue that will change the final result. The surgeon must anticipate this to some degree and make over-corrections in some cases.
A valuable tool for patients is computer imaging. When your surgeon uses a computer to show you what you may look like after rhinopolastyl he is in most cases showing you an ideal outcome (in his opinion). This is the patient's chance to assess their surgeons "taste" or "style" in regard to profile sculpting. Keep in mind that an ethical surgeon will show you what is reasonable to hope for based on your anatomy and his skill- and not just a "dream nose."
In addition to computer imaging, one should look for multiple before and after photos of other patients to assess the quality of results a surgeon is able to obtain.
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