Hump ​​Rhinoplasty

Nasal hump and other features influencing ​​facial harmony: what is a surgical “profiloplasty”?

Removal of a nasal hump restores facial harmony and can be considered a part of a surgical “profiloplasty.” Hump reduction is the most requested procedure in rhinoplasty. However, the harmony of a profile view depends on several interdependent factors. For example, the presence of a hump may be accentuated due to the shape of the nasal dorsum, the position of the root, the projection or rotation of the tip, and the junction between columella and lips. Conversely, surgical manoeuvres confined to the hump could have a detrimental effect on the harmony of other facial features.

What is the best way to treat a dorsal hump? Most well known authorities in nasal surgery recommend the adoption of a global, personalized approach to sculpturing the profile view.

Dr. Palma is an Italian rhinoplasty expert. His pre-operative assessment includes careful analysis of numerous individual variables, such as the sex, height, age, facial conformation, and wishes of the patient. This prudent and personalized method also minimizes the risks of a future revision rhinoplasty.

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Aesthetic and functional issues associated with a dorsal hump

What is a dorsal hump? A nasal hump is a convex protrusion of the nose that may be present from birth or result from trauma. The variety of nose shapes and sizes is virtually infinite, with many variations based on ethnic or geographical backgrounds. A perfectly straight nasal dorsum is not necessarily prettier than a harmoniously arched profile. Nevertheless, many people consider the presence of a hump aesthetically unpleasant. The combination of a hump and a poorly projected nasal tip may be considered undesirable, especially in female patients.

Furthermore, the hump often presents as a sensation of a blocked nose caused by the deviation of the septum, the pyramid, or hypertrophy of the inferior turbinate. The latter is a structure consisting of a boney core and an outer coating of vascular, spongy tissue that can block the normal flow of air in and out of the nose.

In post-traumatic cases, septal deviation often correlates with enlarged turbinates, a common cause of nasal obstruction. The two conditions are related in that the inferior turbinate tends to gradually increase in size in the cavity opposite to the deviation. Therefore the surgeon often needs to reduce the turbinates (turbinoplasty) when repositioning and aligning the septum (septoplasty). The combination of these delicate manoeuvres adds to the complexity of rhinoplasty, where customized design and perfect execution have to intertwine.

The shape and function of the human nose are so intimately dependent that they may well be considered part and parcel of the same issue. Almost no rhinoplasty has an exclusively cosmetic or functional purpose; more often surgery is a successful synthesis of both factors.

Profiloplasty: the modern approach to nasal hump removal

The excision of the hump is the commonest reason for seeing a rhinoplasty specialist. In contemporary surgical practice, however, profiloplasty has replaced the older concept of simple hump reduction. Cutting the cartilaginous portion and chiselling the bone need careful planning, but a natural balance can only result from an all-encompassing approach to the procedure.

Hump excision will also have an impact on the position of the nasal root and tip. In addition, a simple hump excision could produce an optical illusion of a longer and hooked nose. To avoid this problem, it is often necessary to give support and a new position to the nasal tip, and sometimes also to reposition the root. Simultaneously, the contour of the columella and the junction between the columella and upper lip will have to be balanced.

Rhinoplasty aimed at reducing a hump should be thought of as profile adjustment rather than simple cartilage removal. The harmony of the profile depends on several elements, including the shape of the dorsum, the rotation, and the projection of the tip. The features, ethnicity, and gender of the patient also need consideration: male rhinoplasty and the feminization of the nose in transgender patients are very specific example of this principle.

Hump rhinoplasty with Dr. Palma in Milan: throw the foundations for success in surgery choosing the super-specialist of the nose

No matter what terminology we use to describe humpectomy – hump removal, excision, chiseling, or leveling -, it remains the principal reason for seeking rhinoplasty. However, rhinoplasty is far more than the cosmetic correction of an undesirable nasal appearance. Any modification of the nose might have an impact on the delicate function of smell. Any adjustment of the nasal dorsum may affect the anatomical and functional characteristics of airflow, even when the objectives are purely cosmetic.

The harmony of the profile results from the balance of all the elements, so we prefer the term profiloplasty. Even better, we call it YOUnique Rhinoplasty™: the tailor-made surgery conceived and fine-tuned by Dr. Palma. Careful listening to patients’ concerns, a deep understanding of their psychological and emotional state, and attention to pre-operative diagnosis are the grounds for a doctor-patient relationship based on trust and empathy. The rhinoplasty specialist cannot ignore that the nose is made up of several elements, even when the patient complains about a single defect, such as the shape of the nasal dorsum. The success of the procedure will depend on the careful balancing of tip rotation and projection, root depth, arching of the profile, and other adjacent elements.

Preliminary interviews are highly emotional and challenging moments both for the patient and the surgeon, and they can NEVER be replaced by online contacts. Dr. Pietro Palma does not take on patients exclusively based on photos sent via the Internet. For more information, we invite you to call Clinica del Viso (Piazza Repubblica, 21 – Milan – Tel +390263611932 – or Casa di Cura La Madonnina (Via Quadronno, 29/31 – Milan – tel +3902.58395555 –, both well connected to the main international stations and airports. We will set up an interview with the Italian nose surgeon to assess the possibility of reshaping the nose with a surgical hump correction.