Rhinoplasty is often regarded as one of the most complex and custom plastic surgery procedures available. Because of this, there are many different techniques used to accomplish a variety of goals in nasal reshaping. Problems that can be improved through rhinoplasty range from cosmetic to functional and reconstructive, which require different approaches. One of the most common problems in rhinoplasty is the “dorsal hump,” a large hump on the bridge of the nose that can make it appear oversized and not aesthetically pleasing. Here is a look at one of the techniques often used to help resolve a nasal hump: rasping.
The Rasping Technique
To rasp essentially means to file, and rasping is a useful technique in rhinoplasty, since many nasal surgeries involve altering the nasal bones in some way. Rasping files down excess bone or smoothes out rough edges. This is commonly done during a nasal hump reduction.
Rasping has been a technique in rhinoplasty for a very long time, but only recently have tools developed to make the process easier and better than before. Today, powered rasps are becoming more common and are a big step forward in surgical-tool technology. Dr. Bentkover developed a power rasp over 20 years ago and then switched to a diamond drill.
Resolving a Nasal Hump
Fortunately, the nasal hump is a very common cosmetic problem, so most facial plastic surgeons have a good deal of experience in resolving this issue. Rasping alone is often preferred for taking down a small nasal hump, as it does not produce as much trauma as breaking or cutting the nasal bones. However, this is often not possible, and in many cases, the rasp may only be used for smoothing out the nasal bones once the hump has been removed. Osteotomy (breaking of the nasal bones) is often necessary in conjunction with rasping.
In case of a large nasal hump, the bones may need to be broken and re-set to avoid an overly wide nose or an “open roof” deformity, in which the two nasal bones do not come together fully and form a flat opening at the bridge of the nose. These are the main reasons that rasping alone is not always sufficient for dorsal hump removal.
Often much of the hump is actually cartilage, and that can be trimmed with a scissors.
Nasal Hump and Ethnic Rhinoplasty
One of the reasons it is so important to choose a facial plastic surgeon who understands the intricacies of different types of noses, is that people of various ethnic backgrounds often have similar nasal characteristics to those with the same background. For instance, dorsal humps are very common in people of Caucasian and Middle Eastern descent, but less common for those of African or East Asian backgrounds. When choosing your surgeon, you should look for a specialist who has the flexibility to create good outcomes for a diverse patient base.
While it would be ideal if all rhinoplasty procedures had an ideal outcome, this is simply not the case. Aesthetic and/or functional complications can occur despite a surgeon’s best efforts. Rhinoplasty is a complex procedure, and it is difficult to predict every possible outcome or complication. While a skilled surgeon will not use the rasp to the point of removing too much tissue, it is important to understand the risks of surgery and do your best as a patient to help promote a good outcome. If you choose a skilled surgeon, practice diligent aftercare, and maintain realistic expectations, you have a good chance of a successful outcome. If complications do occur that are severe enough to warrant a second surgery, revision rhinoplasty is a good option.
Seek a Specialist
Because rhinoplasty can involve a number of complex techniques, and since no two cases are exactly alike, it is vital for the surgeon performing the procedure to be proficient in many different approaches, and have the ability to tailor the surgery to suit the patient’s needs and facial features. Only a board certified facial plastic surgeon with a focus in rhinoplasty has the skill to predict results and help the patient meet his or her nasal surgery goals.
If you are looking for a seasoned specialist, come to Bentkover Facial Plastic Surgery in Worcester (508-363-6500) or Stoneham (617-247-0033), MA to meet with Dr. Stuart Bentkover. Dr. Bentkover’s focus on rhinoplasty has gained him a reputation as a top-notch surgeon with a high rate of success. He has used a diamond drill to achieve a smooth profile for over 20 years. If you would like to meet with Dr. Bentkover to discuss your rhinoplasty goals, call either location today to schedule a consultation.