A hump or bump on the nose, which many patients would like fixed, relates to a dorsum that is too high. (bridge of the nose or upper third of the nose) When the dorsum is high relative to the rest of the nose, the dorsal line (line from the bridge of the nose to the tip) is not straight which is unpleasing in profile. More pertinently, patients do not like it because they intuitively know that the upper part of the nose is out of balance to the lower part of the nose … it looks too big and thick.
Hump or bump reduction of the nose is one of the most frequently requested reasons that patients want rhinoplasty surgery. Removing a nasal hump often involves more than just trimming down the bone. What makes up most humps of the nose is a combination of bone and cartilage as the hump occurs where the bone of the nose stops and the cartilage of the nose begins. This may seem like a trivial anatomic point but reducing this area involves removing both. Doing so requires a special instrument that levels out the hump but often leaves a flat plateau across the bridge of the nose, known in plastic surgery as an 'open roof' deformity. This is because the bridge of the nose is like the roof line on your house. Trimming off the apex of your roof line will leave the sides of the roof standing where they originally were …. with an open top. To make that open roof close down again and remake a narrow bridge, the sides of the roof must be cut low so they will fall back in together. This is exactly what osteotomizing the nasal bones does, also known as 'breaking or cutting the nose bones'. It is also the rhinoplasty maneuver that may leave you with blacks eyes after. The nasal bones are cut down low and then pushed in to close the open roof.
Not every rhinoplasty requires breaking the bones even if there is a hump. Small humps may be able to be filed or rasped down which will cause no bruising under the eyes after surgery. For this to be effective, the hump on the nose be fairly small being no more than 1 to 2 mms high.