Thursday, April 9, 2020

Removing The Dorsal Hump - Rhinoplasty Surgery

Hi, Dr. William Portuese here in Seattle. Today, I'm talking about dorsal hump removal with closed rhinoplasty. Patients with a large dorsal hump tend to be very self-conscious about that hump from the side profile. And if their nose is crooked they always are turning their head towards the camera at a tangential angle so that their nose looks good without shadow affects. Once we've removed that hump their self-confidence really tends to shine. It really tends to improve. Because they're not having to worry about what angle people are looking at them from. Like a side angle or a three-quarter angle and having to adjust their head position all the time to have a conversation or take a photograph. Take the hump off and the hair's back, and this big smiles and the confidence goes up and they just tend to blossom. The dorsal hump is composed of both bone and cartilage. And it has to be shaved down in order to remove it. So what we do is we make some incisions on the inside of the nose, go in and shave the hump down. Once we shave the hump down we have intermittently, created an open roof, flat top nose deformity. And so we have to then, go in and perform osteotomies in the nasal bones. Osteotomies are little cuts in the nasal bones that allow us to close the open roof created from the hump removal. And that allows the nasal bones to be in a more narrow position that looks refined, feminized and balanced with the facial features. So the surgery itself is a closed rhinoplasty. All of the incisions are placed on the inside of the nose. The stitches are dissolvable. The cast is applied on the bridge of the nose after I've reset the nasal bones more in a narrow position, take and shave the hump off. The cast stays on for about a week. Then there's, anticipate about two weeks of visible bruising and swelling. I take the cast off a week later. And then, there's still, you know, there's bruising and swelling underneath the eyes. And that's gonna take a good two weeks to subside. And then most of the swelling, about 70% of the swelling is gone in about a month after the surgery. About 90% is gone in about three months after the surgery. And then full healing takes about a year. This patient has an over projecting nose with a large dorsal hump. Most of the hump that she has is cartilage. About three quarters of it is cartilage. And about a quarter of it is bone. And that was all shaved down. And I decreased the overall projection of the nose by shaving down the dorsal hump. I did some minor little adjustments to the nasal tip to make sure that it balanced with the bridge line. And then the osteotomies placed in the nasal bones were mandatory in order to close the open roof, flat top nasal deformity that you would see from the frontal profile. So her nasal bones ended up getting narrowed as well. So the whole nose gets smaller. Visibly, the largest amount of change you see on this rhinoplasty is reduction of that dorsal hump and removal of that dorsal hump.

Dr William Portuese
1101 Madison St #1280
Seattle, WA, 98104 USA
206-624-6200
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