Find out what is involved in removing a bony hump from the bridge that was caused by a prior nasal fracture.
In a prior blog post I discussed five things to know when thinking about having a rhinoplasty to reduce a nasal hump. The first item on that list was to find out if your hump is due to excess bone, cartilage or both.
It turns out that the bridge is actually composed of bone in its upper third and cartilage in the remaining lower two-thirds.
When reducing a full bridge your surgeon must determine if cartilage needs to be shaved, bone removed or both.
Today we'll go over an example of a bone only hump reduction.
Bump on bridge from healed nasal fracture
This patient suffered a nose fracture several months prior to seeing me. She noted the development of a new bump on her bridge in the area where her injury occurred. This is common to see as the the injured bone often forms a thick callus in the area in an attempt to mend and stabilize the fracture.
In the photo above you can see how this fracture healing process ended up resulting in a distracting new bump that disrupts the patient's previously straight profile line.
How to smooth out a bony hump on bridge
So how do we as rhinoplasty surgeons remove the bony bump on the bridge in cases Iike this? The most common method is to use what is called an osteotome to treat the area. An osteotome is a fancy term for a medical grade chisel. The osteotome is inserted under the skin of the nose and is used to gently cut the excess bone that makes up the bump. The bony bump is then removed.
Once this step is completed I'll often then refine the reduced bridge further with a rasp (medical grade file). This allows me to smooth the edges of the cut nasal bone and to precisely create the desired profile line. In situations with a very small bump a rasp may be used for the entire reduction without needing to use an osteotome at all.
Before and After Bony Bump Reduction Photos
So let's see how this patient's rhinoplasty was able to straighten her bridge.
You can see how the patient's profile line is now much straighter. In addition to straightening the patient's bridge I also improved her tip projection to bring better balance to her nasal proportions and to further refine her tip.
This oblique view shows how the refinements to the bridge and tip bring better overall balance to the patient's face.
Want to see other patient's photos? Check out more before and after rhinoplasty photos here.
Related Seattle Rhinoplasty Blog Posts:
- Top five things to know about dorsal hump reduction
- Nasal hump removal
- Deciding how much nasal bridge hump to remove
