Removal of Dorsal Hump
Dr. Nassif: After the septoplasty and turbinoplasty we make the incisions a little bit larger inside the nose and we were able to lift up the tissue so we could see the septum. So we just finished releasing all the soft tissue from the nasal skeleton, our next step now is to start removing the hump. We’ll start off with the cartilage part of the hump and then we’ll go to the bony part of the hump.
In Luisa’s situation she had a pretty big hump. So we shaved down the cartilage hump. So I’m still working on removing the cartilaginous hump, I want to make sure that it’s nice and straight. We may have to refine it, but at least we’re starting off on the right track here.
Then we rasp with the little rasp, the bone. So our whole goal was really to soften her profile. So we’re rasping the hump down, or we’re filing the hump down and this is made out of bone. So our whole goal was really to soften her profile and so that was our first main procedure we did with the rhinoplasty is bringing down her hump.
A lot of this hump is composed of cartilage, so we have to go back and take more cartilage in the middle of the nose. This needle is marking where the hump starts forming-give me a pair of pickups- and then everything behind that I’ll start to bring down. We’re going to remove the hump incrementally which means we’re going to do it very softly, gradually, because I don’t want to over correct. We’re starting to get there but we’re not there yet.
Ok, I think I see where to go with that. Take the needle out ok, give me the scissors. Alright, let’s take a peek. Give me the six rasp-right here there’s a little bump right there. Now let me see here. At this point now I’ve taken down primarily most of the hump. I want to get ready to do my osteotomies which are fracturing the nasal bone. And I’m also going to want to give a little more support to the nasal tip. She does not want her nasal tip to change much but to give her a nice profile I’m going to have to add a little structure to that area.
Today I saw Luisa she’s about seven weeks following a closed rhinoplasty, septoplasty, and turbinoplasty. We performed multiple procedures on her to take down her hump, make the middle part of the nose more symmetric, and fix her deviated septum to help open up her airway. The surgery went very smooth it was exactly what I expected. At this point she’s very early in her healing phase, but she’s fine, everything looks great and she’s healing beautiful.