Reduction Rhinoplasty
What happens during a reduction rhinoplasty?
- Osteotomy
- Reduction of septum
- Tip-plasty and Alar-plasty
Isolated Hump Nose Deformity
Hump nose with a flat forehead and low nasal tip
If you have a hump nose but your forehead is also flat and the nasal tip is not projected, the hump nose can be sanded (rasped) down. An osteotomy is not likely to be needed. The dorsum of the nose can be smoothened with your own tissue (deep temporal fascia) or occasionally augmented with an implant or your own tissue.
Depending if you need tip projection, the nasal tip can be augmented with a tip-plasty using your own cartilage.
This is a common scenario in Asian noses.
Hump nose with a large nose and prominent nasal tip
If you have a large nose with a prominent hump and the nasal tips are prominent, you will need a reduction of the hump, as well as the nasal tip.
Depending on the expected size of reduction, the hump may be removed alone or the nasal bones can be osteotomised (fractured) to further reduce the size of the nose.
The tip of the nose will also have to be reduced to create a harmonious relationship between the dorsum, tip and face.
This is commonly encountered in Caucasian patients.
Hump nose with a deviated septum
A hump nose can be associated with a deviated or curved septum. It is important to diagnose this before the surgery, to prevent complications of a deviated nose or recurrence. The deviated septum has to be excised, straightened and reinforced. This is commonly done with spreader grafts to rebuild the nose on a firm foundation. Following, this a tip-plasty can be done to complete the process.
Total Reduction
Narrowing the width of the nose
Osteotomy is not always mandatory. A proper analysis is needed to assess if this is an absolute requirement. This is only required if the nasal bridge is broad and your wish is to narrow it.
An ostetomy is not as scary as it sounds. It is a needed step if you wish to narrow a very wide bony nasal vault. The bones are fractured in a controlled manner using 2-4mm instruments to make precise bone cuts. The incision is done within the nostril so it is well concealed.
Reduction of the nasal septum
In cases where the septum is too large or long, the nasal septum is reduced in precise dimensions so that the nasal tip can sit on a lesser framework.
Tip-plasty + Alar-plasty
Depending on the tip structure, precise suture techniques are usually used to narrow the nasal tip cartilages to further refine the tip to fit the smaller upper and middle nose. The nostrils can also be corrected with the help of an alarplasty.
