Surgically Treating a Dorsal Hump through Filing and Osteotomy

Miami area facial plastic surgeon Dr. Andres Bustillo is known for his specializations in rhinoplasty and revision rhinoplasty, among other surgeries. Many rhinoplasty surgery patients dislike the bridge of the nose, which is the area that spans from between the eyes to just before the tip of the nose. The bridge is partially composed of the nasal bones and the septal cartilage, which often form a dorsal hump. The hump raises the height of the bridge and may cause the eyes to appear smaller and closer together from a frontal view, and the nose to appear too large for the face when viewed from the side. There are two common ways that a dorsal hump can be treated, though when combined, they often create the greatest cosmetic results. See some of Dr. Bustillo’s patients in the Photo Gallery.  The first step in this part of the procedure is performed through the use of a surgical rasp, or sanding tool. The top of the nose is sanded down to reduce the size of the hump. Think of the nose as a three-dimensional triangular shape. When the hump or one angle of the triangle is eliminated, the natural form of the nose is flattened. After the hump is brought down, the bones must be narrowed to prevent an open-roof deformity. This second part of dorsal hump reduction is the osteotomy, when the nasal bones are moved into a different position to close the gap that is created when the hump is filed down. Surgical cuts are made in the bones for the doctor to ensure precision with their new placement. The bones are then moved together to recreate the three-dimensional triangle’s corner side so the nose maintains a normal anatomical shape. Dr. Andres Bustillo MD, FACS is a board certified facial plastic surgeon located in Coral Gables, Florida. The doctor’s office can be reached via telephone at (305) 663-3380, or through the Patient Contact Form.