Dorsal hump

A dorsal hump (nasal hump) is a bump on the bridge of the nose, the line running from between the eyebrows to the tip. Seen in profile, it breaks the straight or slightly concave line of the bridge and is one of the most common reasons for a rhinoplasty consultation.

What it is

The bridge of the nose is made of bone in its upper part (the nasal bones) and cartilage in its middle and lower part. The hump usually sits where the two meet, so it is almost always osteocartilaginous: it has a bony part and a cartilaginous part. Its size and shape vary widely from person to person.

Causes

• Genetics: the most common cause. The shape of the bridge is inherited, and the hump usually becomes more visible once growth finishes, in adolescence.
• Trauma: a knock or a nasal fracture can leave a bump as the bone heals or the cartilage shifts.

Hump and breathing

The hump itself is an aesthetic issue and does not affect breathing. However, it often coexists with a deviation of the nose or septum: in a study of rhinoplasty patients, deviation was present in 83% of those with a hump compared with 39% of those without. That is why breathing function is also assessed before surgery.

Treatment

• Rhinoplasty: the only treatment that removes the hump. There are two main approaches:

  • Dorsal reduction: the excess bone and cartilage are removed and the nasal bones are then narrowed (osteotomies) so the bridge is closed and balanced.
  • Preservation rhinoplasty: in selected cases the whole bridge is lowered without removing it, keeping its natural surface.

  The technique is chosen according to the size of the hump, the shape of the rest of the nose and whether the septum also needs correcting.

• Non-surgical rhinoplasty with hyaluronic acid: small humps can be camouflaged by filling above and below them so the profile looks straight. It does not remove the hump or make the nose smaller, and the effect is temporary. The nose is a delicate area, so it should always be performed by an experienced doctor.