Nasal hump removal in Asians.

Conclusion. When performing nasal hump reduction in Asians, the amount of hump resection should be tailored based on the predicted amount of dorsal augmentation and tip projection needed. Common complications of hump removal can be prevented by conservative hump removal and efficient use of spreader graft or camouflage cartilage grafts. Objectives. The authors present surgical features and results of nasal hump reduction in 51 Asian patients. Subjects and methods. Fifty-one consecutive patients who underwent nasal hump reduction were analyzed retrospectively. Characteristics of the nose accompanying the hump, approaches and techniques used, combined procedures, results and complications were evaluated. Preoperative and postoperative standardized photographs of the face were evaluated to judge objectively the aesthetic outcomes of the surgery. Results. The most frequent aesthetic characteristic accompanying the hump nose was a relatively low nasal dorsum and tip projection compared to the ideal Asian aesthetic norms. An endonasal approach was used for 22 patients (43%) and an external approach for 29 patients (57%). En bloc resection of the bony and cartilaginous hump, followed by rasping was the most commonly used methods for hump resection. Combined procedures included septoplasty (89%), dorsal augmentation with cartilage graft (73%), lateral osteotomy (69%), nasal tip surgery (49%) and spreader graft (39%). Objective evaluation showed complete correction of the hump in 70%, slight under-correction in 26%, and persistent hump (although less than preoperative) in 4%. Complications such as "inverted V" deformity, saddle nose, and nasal obstruction were not encountered.