Dorsal hump reduction, also known as nasal bridge surgery, is an operation that reduces or removes a bump seen on the nasal bridge in profile. A bump is made of bone and cartilage together and is one of the most noticeable features of the nose in profile. At İstanbul Burun Estetiği, our clinic in Bakırköy, Istanbul, we plan hump reduction with the aim of a natural profile that suits the face and preserves breathing function, within a plan made for the individual. This page explains how a bump forms, the methods used to correct it, the risks, recovery and what to consider at the consultation.
What is a dorsal hump and how does it form?
A dorsal hump is a convexity of the nasal bridge that sticks out in profile. It is caused by excess bone and cartilage; surgically this excess is taken away in a controlled way to straighten the bridge.
The nasal bridge, or dorsum, is the line running from the forehead to the tip of the nose. Whether this line is straight, slightly concave or slightly convex in profile can be natural, depending on facial structure, sex and ethnic features. However, a marked bump on the bridge bothers some people from a cosmetic point of view.
The bridge has two parts: the upper part is bone (the nasal bones) and the lower part is cartilage (the septum and the upper lateral cartilages). A hump can appear where these two structures meet and may be formed by excess bone, excess cartilage or a combination of both.
The main causes of a dorsal hump are:
- Heredity and development: Similar nose structure is common within families. The nasal structure becomes more pronounced during adolescence and the hump may be noticed then.
- Injury: After a blow to the nose, bones and cartilage can heal in a way that forms a bump.
- Previous nose surgery: A bump can reappear because of insufficient correction, or scar tissue and cartilage growth during healing.
- Relative hump (pseudohump): Sometimes there is no real bump on the bridge, but the bridge looks prominent because the tip is low or the root of the nose between the eyes is sunken. In that case a bridge reduction alone may not solve the problem; the tip or root also needs assessing.
Nasal profile and facial proportions: how is a hump assessed?
In hump reduction the aim is not to remove the bump entirely but to bring the nose into a profile in harmony with the rest of the face. At the consultation, therefore, the following are assessed together:
- Nasal root (nasion): The point where the nose meets the forehead. This area can be high or low and changes how a hump is perceived.
- Position and rotation of the tip: The direction of the tip, together with the bridge, determines the shape of the profile.
- Lip and chin profile: A receding chin can make the nose look larger, so the facial profile is examined as a whole.
- Length and width of the nose: Whether the bridge needs shortening or narrowing is assessed.
- A profile that suits sex and personal features: For many people, keeping a natural look matters more than a completely straight bridge. In some people a slight convexity or soft slope may suit the face better.
During this assessment photographs of the face are taken from different angles and goals are discussed with them. Photographs are only a means of communication, not a guarantee of the result.
Who may be suitable for hump reduction?
Hump reduction may be considered in the following situations:
- The bump on the bridge bothers the person from a cosmetic point of view,
- The bump looks out of harmony with the facial profile,
- The crookedness or bump of the bridge upsets the overall proportions of the nose,
- Growth is complete,
- General health is suitable for surgery and anaesthesia,
- Expectations are realistic and it is accepted that surgery is not a promise of perfection.
A bump is often seen as a problem in isolation, but it is usually related to the overall structure of the nose. If the tip is low, the root is sunken or the septum is bent, a bridge reduction alone may not be enough. In such cases tip shaping and septal correction may be planned in the same operation. Suitability is decided only after an in-person examination.
How is a dorsal hump corrected?
A bump on the bridge is corrected in two main ways: rasping, or controlled removal (resection) of bone and cartilage. With both methods, additional steps follow so that the bridge closes and looks even.
1. Anaesthesia
The operation is usually done under general anaesthesia. The type is planned with the anaesthetist according to your health history and the extent of surgery.
2. Access to the bridge
The bridge is reached with the open or closed technique. In the closed technique the incisions are inside the nose; in the open technique an extra small incision is made on the columella. For limited bridge reductions the closed technique is often enough; in complex cases the open technique may be preferred. See our closed rhinoplasty and open rhinoplasty pages for details.
3. Reducing the hump
The hump is rasped down with special rasps or removed in a controlled way with sharp instruments. Bone and cartilage parts are assessed separately. The amount removed is decided according to facial proportions and the position of the tip; removing too much can cause the bridge to sink or look unnatural.
4. Open roof and osteotomy
When the hump is removed, a gap (“open roof”) forms between bone and cartilage on the bridge. This gap is closed by moving the nasal bones in a controlled way (osteotomy) so they come together. The bones are moved under anaesthesia with special instruments and supported with a splint afterwards.
5. Supporting the bridge
When needed, spreader grafts or suture techniques are used to keep the internal valves open and to give the bridge an even look. This step matters for breathing function as much as for the cosmetic result.
6. Closure and splint
The incisions are closed and an external splint placed over the nose. The splint is usually removed around the first week at our clinic.
An operation aimed only at the bridge commonly takes about one and a half to three hours; additional procedures or revision can lengthen it.
Procedures that can be combined with hump reduction
Hump reduction can be done alone or planned together with other procedures:
- Tip shaping: When the bridge is lowered, the tip can look more prominent or low. In that case the tip may also need adjusting. See our nasal tip rhinoplasty page for details.
- Septal correction: If the septum is bent, septoplasty can be done in the same operation for breathing function and a straight bridge. This is called septorhinoplasty.
- Adjusting the nasal root: If the root is sunken or too high, an additional correction can be made for profile balance.
- Narrowing the nasal bones: If the bridge looks wide, the bones can be narrowed with osteotomy.
Risks and possible problems
Bridge reduction is one of the most frequently performed parts of rhinoplasty; however, like other operations it carries risks.
- Bleeding, bruising and infection,
- Complications related to anaesthesia,
- Irregularity, steps or roughness on the bridge,
- Sinking of the bridge because of excessive tissue removal (a “saddle nose” look),
- Inadequate correction, so the bump is not entirely removed,
- The bridge forming a bump again over time (from cartilage or scar tissue),
- Internal valve narrowing and difficulty breathing (if the bridge is narrowed too much),
- Asymmetry,
- The need for revision surgery.
Care with thin skin
In people with thin skin even the smallest irregularity on the bridge can be seen. Shaping in thin skin therefore needs very fine work and, when necessary, small grafts can make the bridge smooth.
Limits with thick skin
In thick skin, even when the bone and cartilage shape changes, the skin may not fully reflect it; swelling lasts longer and the result becomes clear more slowly. This is discussed openly together with your expectations.
These risks are assessed individually at the consultation. Smoking, certain medicines and chronic conditions can affect them, so sharing your full health history is very important.
Recovery after hump reduction
Recovery resembles that of rhinoplasty. The timeline below is a general framework; our doctor's instructions always take priority. See our recovery page for more.
| Period | Commonly seen | General advice |
|---|---|---|
| First 24–48 hours | Nasal blockage, slightly bloody discharge, swelling, bruising around the eyes | Keep your head raised, rest, take the medicines advised |
| Week 1 | Bruising, splint, possible stitches | Splint is usually removed now; do not blow your nose |
| Weeks 2–3 | Bruising fades noticeably, bridge swelling continues | Light daily activities are usually possible |
| Weeks 4–6 | Most swelling settles, bone healing progresses | Avoid heavy exercise and activities that put pressure on the nose |
| Months 3–6 | Bridge becomes clearer, tip swelling goes down | Regular check-ups |
| Month 12 onward | Final shape settles | Long-term follow-up |
Bone healing and the importance of the splint
Bones that have had an osteotomy are mobile in the first weeks after surgery, so the splint matters a great deal at this time. Keeping the splint in place and protecting the nose from knocks and pressure helps the bones heal in the right position. Glasses can press on the bridge in the first weeks, so they are used as our doctor advises. The bones become noticeably stable within a few weeks, though full bone healing takes months.
Temporary firmness and tenderness on the bridge
After surgery, firmness, tenderness and temporary numbness may be felt on the bridge. These usually improve over time. It can take months for swelling to go down completely.
When to seek help immediately
Contact the clinic or an emergency service without delay for uncontrolled bleeding, high fever, severe and increasing pain, shortness of breath, or redness and pus around the nose.
Everyday life and aftercare
Because bone healing is involved in bridge surgery, protecting the nose in the first weeks is very important. The tips below are general information and do not replace our doctor's personal instructions.
- Protecting from knocks and pressure: To keep the nasal bones in place, protect the nose from knocks, pressure and touch in the first weeks. Take care in crowds and around children and pets.
- Glasses: Glasses will press on the bridge, so for several weeks special supports or alternatives are used as our doctor advises. Contact lenses may be an option.
- Head position: Keeping your head raised in the first days helps reduce swelling.
- Nose care: Blowing the nose is forbidden in the first weeks. If you need to sneeze, keep your mouth open.
- Washing: The splint must not get wet. Our doctor explains how to wash in detail.
- Exercise: Heavy exercise, bending and heavy lifting are not advised in the first weeks. Contact sports are usually avoided for several months.
- Sun protection: The skin of the bridge can stay sensitive; avoiding sunburn matters for controlling swelling and colour changes.
- Diet and sleep: A balanced diet, enough fluids, and sleeping on your back with your head raised support healing.
Differences in recovery between people are normal. If something worries you, contacting the clinic without waiting is the safest course.
Long-term results and follow-up
The result of bridge reduction becomes clear as swelling goes down and tissues settle. In the first weeks the bridge may look swollen and round; even when the splint comes off the real shape of the nose is not yet visible. In most people a clear improvement is seen in the first three months; the line of the bridge and its relation to the tip settle over 12 months or longer.
In long-term follow-up the following are assessed: whether the bridge looks smooth and natural in profile, any irregularity or steps on the bridge, preservation of breathing function and the balance between tip and bridge. If you notice any unusual change during this time, it is important to contact the clinic.
A fine roughness or small irregularity on the bridge may soften by itself over months. In cases where it is thought necessary, a small additional intervention or revision may be considered, but never in a hurry; the decision is made after the first year, once the nose has settled. No operation can guarantee a result; a small proportion of patients may need an additional correction.
The role of skin thickness in bridge surgery
Skin thickness is one of the factors that most affects the result of bridge surgery. In people with thin skin, small shape changes in bone and cartilage are clearly visible from outside. This calls for delicate, meticulous surgery, but the effect of shaping is sharper and finer. In thick skin, changes in the bone and cartilage beneath are softened as they show through the skin, and swelling also lasts longer. As a result, the same surgical procedure can give different results in different skin thicknesses.
For this reason skin thickness is specifically assessed at the consultation and expectations are set accordingly. In thick skin, the later settling of swelling can require extra patience in some cases. In thin skin, small grafts may be used to keep the bridge smooth. In both cases the aim is a natural profile in harmony with the face.
Before surgery: consultation and preparation
Success in bridge reduction depends largely on correct planning. At our clinic the consultation covers:
- Your expectations: It is important to describe what you want to change on the bridge, how much straightening you expect and how much you value a natural look.
- Examination of the nose and face: The bridge, root, tip, skin thickness, septum and nasal valves are assessed, as well as the lip and chin profile.
- Photographs: Photographs of the face and nose are taken from different angles.
- Health history: Previous operations, medicines, allergies, bleeding disorders and chronic conditions are shared.
- Tests: Blood tests and similar checks are requested for anaesthetic safety.
Before surgery
- Smoking and nicotine products should be stopped for a period before and after surgery.
- Some medicines and supplements that may increase bleeding must be stopped under medical supervision before surgery.
- Fasting instructions before anaesthesia must be followed.
- You need someone with you on the day of surgery and help at home in the first days.
Points to consider when deciding on bridge surgery
People who want to correct a bump on the bridge may find it useful to think about the following before the consultation: How much do you want to reduce the bump? Is there another area of your profile that bothers you apart from the nose (for example the chin or the tip)? Are you aiming for a natural, soft profile or a completely straight bridge? The answers help planning with your doctor.
Whether a bridge reduction alone is enough should also be assessed together with the state of the tip and the root. Sometimes what looks like a “bump” hides a low tip or a sunken root, and a bridge reduction alone does not give the look you want. At the consultation all these factors are considered together.
Common misunderstandings about hump reduction
“Once the hump is removed the nose must be completely straight.”
A natural profile in harmony with the face often looks better than a completely straight bridge. Over-straightening can lead to an unnatural look and a sunken bridge.
“A hump cannot be corrected without breaking bones.”
After a hump is removed, osteotomy is often needed to close the opened roof, but the same approach is not used in every case. In very small bumps, rasping alone may be enough.
“The nose gets smaller once the bridge is reduced.”
When the bridge is lowered the profile changes, but the perception of size changes together with the tip, the root and facial proportions. Bridge reduction alone therefore does not mean “making the nose smaller”.
“Once a hump is removed it never comes back.”
Rarely, a slight bump can form again on the bridge because of cartilage and scar tissue. No operation can guarantee a result.
What affects the cost of hump reduction?
The cost of hump reduction is not one fixed number. The extent of the procedure, additional procedures such as tip or septal correction, the open or closed technique, the need for grafts, the type and length of anaesthesia, hospital and theatre conditions, and post-operative check-ups all affect the price. Because we cannot state a fair amount without an examination, we do not publish a figure here; the exact amount is set in a written quote after your consultation with us. We put in writing what the quote includes and excludes. See our cost page for more.
Hump reduction at our clinic
İstanbul Burun Estetiği is a rhinoplasty clinic in Yalı Ataköy, Bakırköy, Istanbul. Our process has four stages:
- Consultation: Your expectations, health history and nasal structure are assessed together with our doctor; the bridge is examined together with the facial profile.
- Planning: The amount of reduction, the technique, the need for additional procedures, risks and alternatives are shared with you.
- Surgery: The planned procedure is carried out under suitable anaesthetic conditions.
- Follow-up: The splint and stitches are removed at the clinic, followed by planned long-term check-ups.
For patients travelling from outside Istanbul or from abroad, accommodation, the length of stay for the first check-up and follow-up arrangements after returning home should be planned in advance.
Frequently asked questions about dorsal hump reduction
Excess bone and cartilage on the bridge are reduced by rasping or controlled removal; the opened roof is then closed by moving the bones in a controlled way (osteotomy). The operation is done under anaesthesia.
After a hump is removed, the nasal bones are in most cases repositioned in a controlled way. This is done under anaesthesia with special instruments and the patient does not feel it.
You feel no pain during the operation because it is done under anaesthesia. In the following days most people have mild to moderate discomfort that can be managed with painkillers.
Bridge reduction alone commonly takes about one and a half to three hours. Additional procedures can lengthen it.
Usually at around one week; timing depends on our doctor's assessment.
If the bridge is narrowed too much, internal valve narrowing and breathing problems can occur. Breathing function is therefore protected in planning, and grafts or septal correction are added when needed.
Rarely, a slight bump can form again because of scar tissue and cartilage healing. No operation can guarantee a result.
For desk work most people return in about 1–2 weeks; physical jobs may take longer. This depends on our doctor's assessment.
Heavy exercise and sports with a risk of knocks to the nose are usually avoided for several weeks. Gentle walking may be possible earlier with our doctor's approval.
No. It is considered if the bump bothers the person and is out of harmony with the profile. In some people a natural slope may suit the face; the decision is made together at the consultation.
Reach us by phone, WhatsApp or email to arrange a consultation. Our clinic is in Yalı Ataköy, Bakırköy, Istanbul.