Who is suited for aquiline nose correction? The method varies depending on the hump shape and nasal tip height

Aquiline nose correction is well-suited for people with a prominent hump in the middle of the nasal bridge that affects the profile's appearance. The appropriate method varies depending on the hump shape, nasal bridge curvature, nasal tip height, and whether it is a first surgery or revision. Treatment may involve not only shaving the hump but also repositioning bone and supporting the nasal tip.

What is involved in correcting an aquiline nose?

There are two main approaches: shaving down the hump and reconstructing, or lowering the entire dorsum while preserving the connection between the nasal bone and cartilage (dorsal preservation)[1][2].

In the shaving method, removing a large hump can result in separation between the left and right nasal bones (open roof deformity)[3]. To address this, the bone is cut and repositioned to close the gap[3][4].

Does the hump shape affect which method is better suited?

Yes, it does. A V-shaped hump with a single bend point is generally considered better suited to the dorsal-preserving method[1].

Conversely, when the upper nasal bridge has an S-shaped curve, the shaving and reconstruction method should be strongly considered[1]. First-time surgery patients with a sturdy septum are in favorable conditions for the dorsal-preserving method, while revision patients or those with a thin or weak septum are at a disadvantage[1].

If the nasal tip is low, is it enough to just remove the hump?

It depends on the nasal tip height. According to literature, when a normal nasal tip height is present and the hump is removed, the tip may drop, necessitating support with cartilage[4].

Lowering only the hump can disrupt the overall balance of the profile. The nasal tip height and orientation must also be considered when deciding how much to lower the hump.

What about patients with a bent nasal bridge?

The curvature can sometimes be corrected at the same time. According to literature, by removing the hump and cutting the left and right bones simultaneously, the curvature can be straightened and the profile improved[3].

However, the dorsal-preserving method is listed as unfavorable for patients with significant left-right asymmetry in the nasal bridge line or an excessively wide bridge[1]. In aquiline noses with curvature, we take particular care to carefully assess which method's conditions apply.

What are the risks?

Literature identifies the following complications of hump removal: persistent separation between nasal bones, saddle nose (depression of the nasal bridge), and irregularities of the nasal bridge[4]. The shaving method can result in irregularities or asymmetry, particularly when the nasal bone is thin[2].

The dorsal-preserving method, when performed on unsuitable noses, may result in inadequate outcomes, and subsequent adjustments can further destabilize the shape[1]. It is important to understand the strengths and limitations of each method.

Which of the two methods is superior?

At present, there is no decisive evidence that one method is clearly superior[1]. Reports of the dorsal-preserving method for aquiline noses in Asian patients are limited, with only 9 patients followed for 6 months or longer[5].

For this reason, it is more reliable to ask which conditions apply to your nose shape rather than choosing based on the method name.

Things to confirm before proceeding

There are three benchmarks to consider. First, whether the hump is V-shaped or S-shaped, and whether the nasal bridge is bent[1]. Second, whether the nasal tip will need support after hump removal[4]. Third, whether this is a first surgery and whether the septum is sturdy[1].

Which method suits your particular hump cannot be determined from an article alone. Have a doctor examine your nasal bone and cartilage shape and nasal tip height during consultation to confirm.