BEFORE AND AFTER
DR. SHAH’S PHILOSOPHY
Dr. Shah’s approach to Dorsal Hump Removal is tailored to each patient. As a leading author of over 50 scientific articles (insert link to Articles Page https://www.shahfacialplastics.com/articles) and an instructor at the University of Chicago, Dr. Shah’s focus is on utilizing scientific approaches to improve your dorsal hump for the best possible outcome, both functionally and aesthetically.
TECHNIQUE FOR DORSAL HUMP REMOVAL
Remove Both Upper Lateral Cartilage and Cartilaginous Hum
Solely removing both the upper lateral cartilage and the cartilaginous dorsum is a common technique. This is one of the more common methods of hump removal since it is simple. The technique can be used in patients with small humps and wide internal nasal angles but has a risk of overly narrowing the middle portion of the nasal airway which is sometimes called an Inverted-V Deformity (see below for explanation). Some patients like a narrower nose and can account for this type of hump removal particularly patients with wider noses.
Suture Back Upper Lateral Cartilages
Here, the surgeon is going to first separate the upper lateral cartilages from the bridge of the nose. The elevated cartilage can now readily be seen and taken down without risk to the upper lateral cartilage. Once the surgeon is satisfied with the bridge appearance. The upper lateral cartilages are simply sutured back in position.
Separate the Upper Lateral Cartilages and Remove Cartilaginous Hump Then Insert Spreader Graft
Instead of folding the upper lateral cartilages, here the surgeon will use a spreader graft to open up the airway. To find out more about what a spreader graft is, click here.
Remove the Upper Lateral Cartilage and Cartilage Hump and Replace with Spreader Grafts
Instead of just leaving the patient with missing upper lateral cartilage, here the surgeon will use cartilage to replace the missing tissue. These grafts are placed along the dorsum and can extend all the way into the nasal tip and spread the angle out and are called spreader grafts. These grafts can help with breathing and maintaining stiffness of the upper lateral cartilage and improving opening of the valve.
ALTERNATIVES TO DORSAL HUMP REMOVAL
The alternative to nasal hump removal is the use of nonsurgical rhinoplasty. The main issue with nonsurgical rhinoplasty, however, is that the nose is actually made bigger rather than smaller. Nasal humps are made to look straighter rather than improved. Typically, filler is added to the radix of the nose for best results.
Real Patient Testimonial
Some quick background: Prior to my revision rhino/septoplasty with Dr. Anil Shah approximately 1 year ago, I had been modeling on a very infrequent level and got booked for only about a photoshoot a month, largely due to the huge amount of time I had to dedicate to contouring my nose before photoshoots and because I couldn't ever take shoots where I'd have to come in with a fresh face (no makeup). Today, I’ve been chosen to represent major brands (including from Microsoft and Mercedes-Benz) and average about 3-4 shoots/week, if not more. People have even compared my nose to that of the Miss Venezuela Miss Universe 2017 contestant and you can see in the photos the resemblance is definitely there! Needless to say, I'm absolutely thrilled with the results and if I had the choice to go back in time, I'd do it again in a heartbeat with the same amazing team, only sooner! When I started modeling about 3 years ago, I was unsure of if I could ever really turn it into a career because my features just didn't fit me without makeup, but I enjoyed modeling so much that I decided to at least look for a doctor with a proven track record for producing results in revision rhino/septoplasty with the highest care taken for both functionality and aesthetics. Not only would s/he have to open up my airways, but for the surgery to be worth it, I'd also need to have my nose slimmed and my very bulbous tip refined. At first, after contacting about 15 or so doctors, I thought it was impossible to find a physician that was skilled enough to craft a beautiful nose while still correcting the breathing difficulties that persisted after my first surgery ~12 years ago to fix a deviated septum. Finally, after researching RealSelf reviews and photos for about a year and a half (!!) I stumbled upon Dr. Shah's amazing results at equally amazing price points. I was excited to take the surgery decision seriously, but the only thing was--he is located 4.5 hours away from me (a totally different state) so I was worried I'd have to keep looking because the entire trip would take about 9 hours just driving time. Luckily, Dr. Shah holds all his patients' satisfaction and comfort at highest regard, and his team promptly set up a remote Skype appointment with me, where he could tell me his initial thoughts on what could be done. After that first virtual appointment, I was ready to make the 4.5 hour drive into the office for an in-person consultation and was ecstatic to find out my seemingly impossible goal was an actually possibility at an unbelievable value (definitely the most affordable of all the doctors I had talked to). Maybe the best thing about Dr. Shah is he is never in it for the money. In fact, he gave me several options, one of which was to do nothing. After seeing the virtual predicted results, I was absolutely certain I wanted to get the surgery, but was so appreciative that he didn’t try to pressure me into anything. The whole staff was so supportive of me and always kept a completely clear and open line of communication with me be it face-to-face, email, or via phone. Leading up to the surgery, they gave me all the information I needed to have the perfect pre-surgery prep and an amazing recovery, and the surgery and recovery went so smoothly I almost couldn’t believe it. For follow-up appointments, he and his team worked with me to do virtual appointments and if I had to come in, they were very accommodating of my time and drive. What’s amazing too is that even when I have to make multiple facial expressions, my nose looks perfect in every shot and never loses the integrity of its shape or it’s feminine profile. Now looking back at everything, I am 100% certain I found the dream team! Needless to say, I decided to move on with the surgery and it remains one of the best decisions I've ever made for my career and relationships (my makeup routine has been slashed from a few hours to mere minutes and most days I don’t wear makeup at all). I couldn't be more grateful for the time and confidence Dr. Shah and his team have given me back. His expertise in acheving the perfect aesthetic and experience in challenging cases coupled with his incredibly reasonable rates (trust me, I shopped around for 2 years so I know!!) have made him now my go-to physician for all things from skin care to filler, even with the 4+ hour drive both ways. Even when other models have talked about getting procedures done, there’s only one team I recommend—Dr. Shah and his team!
Recovery time varies from patient to patient. Most patients are able to return to work at one week. The patient will generally like the appearance of the nose at around one month and the nose will begin to photograph well at around three months. Final healing (including bone portion and bridge of the nose) is around one to two years.
Frequently Asked Questions
Is there a best method of hump removal? Which do I prefer?
They all have their merits and hump removal is based on patient’s anatomy. Surgeons should vary their technique to accommodate their patient’s goals. Consultation is important.
Can you create a perfectly smooth dorsum?
Palpation of the bridge almost always has some little irregularities. Visual appearance is most important of the nose as is function.
Will making my nose wider improve my breathing?
A wider nose does not necessarily breathe better than a narrower one as the nose is extraordinarily complex. There are many parts of the nose which contribute to breathing and the sensation of breathing is highly subjective. How breathing feels to a patient is perhaps the most important.
Can these techniques be used to straighten a crooked bridge?
Yes a combination of these techniques can be used along with others to straighten the nasal bridge.
What are some controversies of nasal hump removal?
A common issue many patients have after a revision or even some primary rhinoplasty is excessive width along the middle portion of the nose. The vast majority of rhinoplasty surgeons will utilize large bulky grafts which may not help all patients functionally or even aesthetically. Dr. Shah has developed a technique to maintain a natural line without creating excessive bulk along the middle portion of the nose.
What Makes Dr. Shah’s Approach To Dorsal Hump Removal Different From Other Surgeons?
Typically, Dr. Shah tries to avoid the use of grafts when possible. Most surgeons resect rather than respect the upper lateral cartilages and then place spreader grafts or don’t place any grafts at all. The main issue is that the nose can either be too narrow with an inverted V or too wide with spreader grafts. The “peel and unpeel” technique removes the cartilage and attempts to replace the upper lateral cartilages back to their original configuration. In some cases, particularly in crooked noses, revision noses, and noses where the upper lateral cartilages are absent or small, grafts are used to improve the function and flow of the nose. Dr. Shah also uses measurements throughout the case to make sure your nose is as precise as possible.
Dr. Shah is an expert rhinoplasty surgeon in Chicago and a leading authority in removing dorsal humps. His award winning practice focuses on improving the nose and looking natural. His office is located in Downtown Chicago on the historic Miracle Mile of Michigan Avenue. Patients from Illinois, Indiana, and from all around the Midwest and the world seek him out for his natural results which respect nasal anatomy and function.