The nose is the most crucial feature for facial aesthetics, significantly influencing overall appearance. A hump nose is a congenital deformity characterized clinically by a broad nasal bridge with an angular protrusion forward. Often called the "king of facial features," the nose plays a vital role in facial harmony. Thus, a hump nose can disrupt facial balance and facial feature coordination.Today, our plastic surgery experts introduce several hump nose correction techniques, hoping to assist those in need.
First Method for Hump Nose Correction:
Subperiosteal and subcutaneous dissection. Insert a small curved scissors to dissect all movable and fixed components of the nasal dorsum. Separate the alar cartilage, lateral nasal cartilage, and upper portion of the septal cartilage from their overlying skin. Then, using a periosteal elevator, separate the nasal bone from its overlying periosteum, muscles, and skin, and also separate it from the underlying mucosa.
Superficial dissection range: extend superiorly to the nasal root and laterally to the maxillary frontal process.
Second method:
To narrow the nasal dorsum, use a periosteal elevator to separate the maxillary frontal process from its overlying periosteum and soft tissues. Then, using an electric or pneumatic reciprocating saw or bone saw, section the maxillary frontal process at the nasofacial junction while simultaneously making a transverse cut through the bony tissue above the nasal bone. Aim to section as close as possible to the origin of the maxillary frontal process to prevent step formation.
If a step forms, partial osteotomy can eliminate it, followed by manually pushing the maxillary bone toward the midline with the thumb.
If the patient's nasal base is not wide, the resected superficial layer of the hump can be trimmed and reused for grafting onto the nasal bridge. Alternatively, a thin silicone nasal splint can be implanted to reshape the nasal bridge.
Third method:
For incisions, foreign practices predominantly use intranasal approaches, which lack direct visualization and present greater technical difficulty. Overseas, external nasal incisions are favored for their superior exposure and ease of manipulation, though they leave visible scars on the nasal tip.
Fourth method:
Remove the hump by chiseling away the pre-marked protruding nasal bone and lateral nasal cartilage using a bone chisel, then file the area smooth. Bone scissors may also be used to trim the hump. Our hospital employs state-of-the-art equipment that significantly improves bone removal techniques, making the process simple, smooth, painless, and highly effective.
Fifth Method:
Correcting lower nasal deformities: If accompanied by excessive length in the lower nose, dissect the lower end of the lateral nasal cartilage and remove an appropriate portion. For drooping nasal tips, make an incision behind the medial crus of the alar cartilage and remove a suitable segment from the anterior end of the septal cartilage. Then suture the edges of the incision, connecting the columella to the septum on both sides.For cases with concurrently wide alar cartilages, resect portions of the upper and lateral borders of the alar cartilages. If the nasal tip is excessively prominent, use the excised nasal bone or cartilage for augmentation and support.
Postoperative fixation is crucial during treatment. Proper fixation preserves the intended surgical outcome, while improper fixation may compromise results or cause secondary deformities. Therefore, the principle of fixation is to apply uniform pressure both inside and outside the nose to maintain the designed aesthetic shape and prevent secondary deformities.