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

Patient Overview:

Today’s patient has a pronounced dorsal hump and irregularities on the nasal bridge, with a significantly drooping nasal tip. The goal is to eliminate the 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 line, additional cartilage needs to be placed between the tip and the hump, and also in the glabella (the space between the eyebrows).

Additional Considerations:

Severe dorsal humps are often associated with a deviated septum. Correcting the deviated septum is crucial. To prevent the nose from drooping further when smiling, the removal of the nasalis muscle (which causes the nose to droop) will also be performed.

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

Outcome:

The surgery was completed successfully, and we look forward to the patient’s swift recovery.