Surgical Record from October 8, 2019: Rhinoplasty for Dorsal Hump and Drooping Nasal Tip (Deviated Septum) > O.P Column

 

Patient Overview:

Today’s patient presents with a pronounced dorsal hump, irregularities on the nasal bridge, and a significantly drooping nasal tip. The goal is to eliminate the dorsal hump and lift the drooping tip.

Given the height of the dorsal hump, using a standard silicone implant would result in an excessively high nose. While some patients only want the hump removed, in this case, the drooping tip means that removing just the hump would create an imbalance. To achieve a straight and balanced profile, additional cartilage needs to be placed between the tip and the hump, and also in the glabella (the area between the eyebrows).

Additional Considerations:

In severe cases of dorsal hump, the septal cartilage inside the nose is often deviated. Correcting this deviated septum is crucial. To address the issue of the nose drooping further when smiling, the removal of the nasalis muscle (which contributes to the drooping) will also be performed.

Patients with severe dorsal humps often have thin nasal skin, making it essential to create a smooth profile to avoid visible irregularities. If the skin is too thin, the bone-sculpting may become noticeable. Due to these challenges, a thin silicone implant might sometimes be used. However, for patients with pronounced dorsal humps, I generally recommend against using silicone implants as the nasal bridge is usually already high. I believe that a slightly irregular surface is preferable to having silicone inside the body. Nevertheless, minimizing visible irregularities remains a top priority.

Outcome:

The surgery was completed successfully, and we anticipate the patient’s swift recovery.