Seattle Rhinoplasty Case Study: Taking down a bump on the bridge
One of the most common nasal features that patients want addressed during rhinoplasty is the hump, or bump, on the bridge. This fullness to the profile tends to masculinize the nose and lead to a nose that dominates the face. Taking down a dorsal hump involves shaving down the cartilage and bone that forms the bridge. Many people are surprised to hear that no skin is removed from the bridge during surgery. The excess skin actually shrink wraps around the smaller nasal framework. In patients with large bump removals this redraping can take many months.
Refining nasal profile with hump removal before and after photos
Lets go through some before and after photos to see what goes into improving the profile line. This patient came to me looking to improve her nasal appearance.
Her before photo on the left shows a significant dorsal bump and somewhat over-projected tip. Using an open rhinoplasty approach I was able to take down the cartilage and bone that was leading to the fullness on her bridge and create a more natural, refined profile line. I also deprojected the tip conservatively and placed what's called a radix graft to further enhance her results. The after photo on the right was taken 2.5 years following her surgery.
What is a radix graft?
A radix graft is a carved piece of cartilage (often from the septum) that is placed at the upper aspect of the bridge (the radix) near the area between the eyes. Some patient's humps are exaggerated in appearance by a weakness, or under development of the radix.This patient is a great example of how placing a radix graft during rhinoplasty surgery can help minimize how much tissue needs to be removed along the bridge. At the same time a radix graft can help prevent an overly scooped out, ski slope nose.
This schematic shows how adding a portion of the patient's cartilage at her radix (oval on the schematic) allows for less of the remaining bridge to be removed. This results in a strong, natural appearing profile that does not look operated on.
You can see more before and after rhinoplasty photos of this patient and learn more about her surgery here.
