Hump Nose: Nasal Hump Removal in Frankfurt

In brief: A nasal hump is a raised area on the bridge of the nose that always consists of a bony part and a cartilaginous part. It is removed surgically by carefully reducing both parts, usually combined with narrowing the nasal bones. The external splint stays on for about two weeks, and most people feel ready to be seen in public after two to three weeks. The final result becomes visible after one to several years.

Hardly any sentence comes up in my consultations as often as this one: "The hump bothers me." Many of my patients have carried this thought with them since their teenage years. They turn their head away in photos, avoid looking at their profile in the mirror and at some point typed "hump nose removal" into a search engine. There they usually find the sentence that the hump is "simply shaved down".

This is exactly where the misunderstanding begins. A nasal hump is not a bump that you file away and everything is fine afterwards. It is part of a structure of bone and cartilage that supports the bridge of the nose, keeps the airways open and shapes the profile of the entire face. Removing something in one place changes the balance in several others.

I have been operating on noses since 2002. In that time I have performed around 9,000 procedures on the nose, including corrections of the nasal septum and the turbinates. About half of my operations are revision procedures. So I very often rebuild noses that have already been operated on. Many of these noses originally had "only" a hump. In this article I therefore explain not only how a nasal hump develops and how I correct it, but also why results sometimes disappoint only years later and what you should look for when choosing a technique.

What a nasal hump is

To understand the hump, it helps to take a brief look at how the nose is built. The upper third of the nasal bridge consists of bone, the two nasal bones. The lower two thirds are made of cartilage: the nasal septum and the upper lateral cartilages on either side. So the nose is largely elastic.

Where bone and cartilage meet lies the so called keystone area, the keystone of the nasal bridge. This is exactly where the hump forms. And that is why a nasal hump is always mixed: it consists of a bony part and a cartilaginous part. A purely bony hump without a cartilaginous transition does not exist, and neither does a purely cartilaginous one.

The bony part of the hump

Depending on the nose, the bony part makes up about one third to one half of the hump. How large it is depends on how long and how wide the nasal bones are. During the examination I feel it as the firm, immovable part of the elevation. It cannot be pressed in and does not give way.

The cartilaginous part of the hump

Below the bone, the hump continues into the cartilage. This part is created by the height of the nasal septum, which pushes the nasal bridge upwards from the inside. When I palpate it, I feel it as a flexible area that springs back slightly. The transition between the firm and the flexible part already tells me a lot about the later operation during the consultation.

Why is this distinction so important? Because bone and cartilage are treated in completely different ways. Bone is filed down finely, cartilage is reduced layer by layer and often additionally supported. A hump correction therefore never consists of a single step, but always of two coordinated steps within the same operation. If only one of the two parts is addressed, the result is a nasal bridge that does not run harmoniously in profile.

How a hump nose develops: genetics, growth, injury

Genetics

Most hump noses are inherited. When patients show me family photos, I often recognise the profile of their mother or grandfather. The shape and length of the nasal bones, the height of the nasal septum and the thickness of the skin are passed on. A hump is therefore not a malformation but a variant of anatomy, which many people find full of character and others find bothersome.

Growth

The hump usually becomes visible during puberty. During this time the nasal bones and the nasal septum grow considerably, and the profile changes within a few years. Many of my patients tell me that they first consciously noticed the hump at fourteen or fifteen. A correction only makes sense once the growth of the face is complete.

After injuries

A blow during sport, a fall in childhood or an accident can create a hump or enlarge an existing one. If the nasal bone breaks, the bone sometimes heals with a thickening, a so called callus, and the nasal bridge develops a step. After an injury the nasal septum is often displaced as well. Then it is not only about the profile, but also about a crooked nose and about breathing.

Why a hump is more than a curve: the open roof

I consider this section the most important of the whole article, because it explains one of the most common reasons for an unsatisfactory result after hump removal. And it is surprisingly rarely explained.

In consultations I like to compare the nasal bridge to the pitched roof of a house. The two nasal bones are the roof surfaces, which meet at the top in the ridge. The hump sits exactly on this ridge.

Now imagine cutting a third off the top of the roof. The ridge has gone, but the two roof surfaces end openly, with a gap between them. Rain would get in. This is exactly what happens when a hump is removed: an open roof is created. The two nasal bones stand freely next to each other, and the nasal bridge is wider at the top than before.

To close the roof again, the lateral nasal bones have to be released and brought together in the middle. This step is called an osteotomy. In everyday language people say the nose is "broken". In fact, the bone is divided in a controlled way along precisely defined lines and repositioned.

If this step is left out, the open roof remains. In the first months this often goes unnoticed because the swelling covers the gap. After one to two years, once the swelling has fully subsided, indentations appear on the nasal bridge that can be seen and felt through the thin skin. Some patients even find these spots painful. The nasal bridge looks too wide and flat at the top, even though the hump is gone.

Nasal hump removal: the techniques

There are different routes for hump nose surgery. Here I describe how I proceed myself and why, and I also explain the techniques I deliberately do not use. You should know the differences before you decide on a surgeon.

Reduction and osteotomy

Classic hump correction removes the hump and then closes the open roof with an osteotomy. In the past I removed the bony part with a small chisel. For about ten years I have been working with a system of ten rasps, which I use one after the other: first coarse, then increasingly fine. The last one is a diamond rasp coated with particularly fine diamond dust. With it I smooth the surface of the bone until no edge can be felt any more.

The rasps are straight or slightly curved. This allows me to shape the nasal bridge along a clear line, even where it naturally runs with a slight curve. I reduce the cartilaginous part layer by layer and check the transition in the keystone area several times by sight and touch. Between the individual steps I repeatedly irrigate the surgical area so that no fine bone particles remain under the skin. Such particles can later become visible as small irregularities.

I then close the open roof with the osteotomy. Afterwards I stabilise the nasal bridge with so called spreader grafts. These are narrow strips of cartilage, usually the patient's own cartilage from the nasal septum, which I place on both sides between the septum and the upper lateral cartilage. They keep the internal nasal valves open, protect breathing and give the nasal bridge a calm, even line. As a rule I use spreader grafts in every hump correction.

There is an alternative, the so called spreader flaps. Here the upper lateral cartilages are folded inwards instead of adding extra material. I prefer the grafts because, in my experience, folding the cartilage tends to widen the nasal bridge. Especially for women who want a fine nasal bridge, that is a disadvantage.

One last step is indispensable for me: under the thin skin of the nasal bridge I place a collagen fleece. It is meant to prevent the skin from sticking to or growing into the smoothed bone edges. The fleece is gradually broken down by the body.

And what about piezo or ultrasound? Many patients ask me this, because ultrasonic rhinoplasty has received a lot of attention in recent years. Here the bone is removed with a vibrating instrument. I have tried the technique and deliberately decided against adopting it in my operations. It extends the operation by about half an hour, and I see no benefit in it for my patients. With my rasps I can work in straighter lines. When shaving with piezo, small dents can form in the bone depending on the experience of the surgeon. In the end, what matters is not the instrument but the precision of the hand that guides it.

Preservation rhinoplasty

Preservation rhinoplasty follows a different approach. The hump is not removed. Instead, the entire nasal bridge is lowered as one unit. To do this, a strip is removed from the nasal septum and the bony pyramid is moved downwards. Depending on the technique, this is called let down or push down. The idea behind it: the natural surface of the nasal bridge is preserved and no open roof is created.

I do not use these techniques and advise my patients against them. The reason lies in what I see in my revision consultations. In patients who had been operated on with let down or push down, I have repeatedly seen a narrowing of the bony pyramid. The lateral nasal bones had been displaced inwards into the nasal cavity and had considerably reduced the airway. Those affected suffered greatly from obstructed nasal breathing, and such a situation is difficult to correct.

In addition, the nasal septum is the load bearing element of the nose. With these techniques it is deliberately weakened so that the nasal bridge can sink. I prefer to build on a stable foundation that I reinforce with targeted support. Supporters of preservation rhinoplasty point to natural looking lines and a preserved nasal bridge. I respect this view, but based on my experience with previously operated noses I weigh it differently. The specialist literature has so far assessed preservation rhinoplasty inconsistently, and there are colleagues who report good results with these techniques.

Open or closed

Rhinoplasty can be performed closed or open. With the closed technique the surgeon works exclusively through incisions inside the nose. With the open technique a small incision is added on the columella, the strip of skin between the nostrils. This allows the skin to be lifted, and the entire framework lies under direct view.

I always operate on a hump open, as part of an open septorhinoplasty. There are several reasons for this:

• Direct view: I see every edge and every step instead of only feeling them through a narrow tunnel.
• Thorough irrigation: I can irrigate the bone debris several times and completely. In my experience, residual humps or fine bone particles remain more often with the closed technique.
• Spreader grafts: They can be placed and fixed precisely through the open approach. With the closed technique this is hardly possible.
• Collagen fleece: I also place the fleece under the skin of the nasal bridge through the open approach, exactly where it is needed.
• Experience from revision surgery: Previously operated noses can only be reconstructed reliably with the open technique. I therefore also use it for primary operations, to create a stable foundation from the start and to keep the risk of a further procedure as low as possible.

The open technique also has disadvantages, which I always address in the consultation. It leaves a small scar on the columella, which is usually barely visible once healed. The swelling, especially at the tip of the nose, can last somewhat longer. For me the advantages of precision clearly outweigh this.

Hump nose without surgery: what hyaluronic acid can and cannot do

Many patients ask whether a hump nose can be corrected without surgery. The honest answer: hyaluronic acid cannot remove a hump. It can only disguise it visually by filling the areas above and below it. The nose does not become smaller as a result, it becomes slightly larger.

This only makes sense in one particular situation: when the nose is rather small and delicate overall and there is a small hump. Then I can slightly fill the transition between forehead and nasal bridge, the so called radix, and lift the tip of the nose by about one millimetre. The nasal bridge looks straighter in profile even though the hump is still there.

For a large, long nose with strong nostrils I advise against it. Any filler makes an already large nose even larger. Women in particular are usually unhappy with this result. Here surgery is the more honest route.

It is also important to know that the nose is one of the regions where injections must be carried out with particular care. The blood vessels lie close under the skin, and in rare cases filler material can block a vessel. That is why hyaluronic acid treatment of the nose belongs exclusively in experienced medical hands. You can read more about this in my article on rhinoplasty without surgery.

The hump nose operation with us

The consultation

Everything starts with a detailed personal conversation. I examine the nose from the outside and inside, palpate the hump and check breathing. I want to know what exactly bothers you and what you would like. If you bring a photo, for example of a nose you like on someone else, I am happy to see it. That way I see what you are dreaming of and can tell you openly whether your nose can be changed in that direction.

I then show you in a 3D simulation how a change could look in your face. The simulation is not a promise but a tool for understanding each other. It helps us both develop the same idea of your goal, and it also makes differences visible.

There is one sentence I say in almost every consultation: perfect symmetry does not exist in the face. Our two halves of the face are different, and the right and left side of the nose also differ if you look closely. Even the skin of the two nostrils is often different. I aim for the greatest possible harmony, but nobody can honestly promise a mirror image nose.

In the consultation I also inform you about all risks and alternatives. This medical informed consent discussion in person is required by law and cannot be replaced by any article, including this one.

The operation

The operation takes place at the Berger Klinik in Frankfurt under general anaesthesia. A primary rhinoplasty with hump removal takes me about two to two and a half hours. For around ten years my patients have stayed in the clinic for one night after the procedure. The next morning I see you in person before you go home.

At the end of the operation I place small tubes in the nose and an external splint on the nasal bridge. The splint protects the new shape during the first days, when bone and cartilage are still mobile.

Aftercare

Follow up appointments take place in our practice. There I remove the tubes, stitches and splint and accompany you through the months of the swelling going down. I offer consultations in Frankfurt and in Zurich. Surgery takes place exclusively at the Berger Klinik in Frankfurt.

Healing: splint, swelling, when you see the result

Healing after a hump correction happens in stages. The following time frames are guide values from my practice. Every nose heals at its own pace.

• 4 to 7 days: The tubes are removed.
• 14 days: The external splint is removed. Working from home is usually possible again.
• 2 to 3 weeks: Most people feel ready to be seen in public again, more likely after three weeks.
• 3 weeks: Return to the workplace.
• about 4 weeks: A large part of the new shape is already recognisable.
• 6 to 8 weeks: Sport is allowed again.
• 8 weeks: Light glasses may be worn again.
• 3 months: Heavy glasses are possible again as well.

Why can glasses only go back on the nose so late? Because they rest exactly on the area where the nasal bones heal after the osteotomy. Weight too early can shift the bone or cause pressure marks.

Seeing the final result takes patience. How long it takes depends mainly on the thickness of your skin:

• Thin skin: about one to two years
• Medium skin: about two to three years
• Thick skin: up to four or five years, especially at the tip of the nose

That sounds long, and I still tell every patient honestly. The good news: regardless of skin thickness, a large part of the change is already visible after about four weeks. The remaining time refines the lines. Whether the tip of the nose should be changed at the same time is something I discuss individually. You can find more about this in my article on nose tip correction.

Hump nose in women and men

A hump nose in a woman is corrected differently from a hump nose in a man. That is not due to the technique but to the goal. The nose has to suit the face, and the faces of women and men follow different proportions.

Hump nose in women

My aesthetic ideal for women is a fine, straight nose with a straight bridge and a slightly lifted tip. I usually shape the angle between the columella and the upper lip, the nasolabial angle, at between 100 and 110 degrees in women. This makes the profile look clear and soft at the same time. It is important to me that the nasal bridge does not become too narrow. That is why spreader grafts play a particularly important role in women.

Hump nose in men

In men the nasolabial angle is closer to 90 degrees. The nasal bridge should be straight or even very slightly convex. If it is lowered too much in a man, a curved line develops that looks feminine. That has to be avoided at all costs.

I therefore sometimes advise men to keep a small remnant of the hump, a minimal elevation that gives the profile character. In the 3D simulation I show both variants side by side: the completely straight nasal bridge and the one with a slight elevation. The patient makes the decision. My job is to show him the differences in such a way that he can really judge them.

Risks and what can go wrong

Every operation carries risks, and a hump correction is no exception. These include the general risks of any operation under general anaesthesia, secondary bleeding, infections, bruising and swelling. Sensation at the tip of the nose can be reduced for several months. Nasal breathing can change. And the result can differ from the idea we discussed together.

Specifically after hump removal, I see the same problems again and again in my revision consultations:

• Residual hump: The hump was not removed completely and becomes visible again once the swelling has gone down.
• Contour steps: Bony steps or edges on the nasal bridge, usually because the filing was imprecise.
• Open roof: A nasal bridge that is too wide, with indentations, because the lateral nasal bones were not repositioned.
• Nasal bridge too narrow: If no spreader grafts were used, the edge of the nasal septum often lies unprotected under the skin. The nasal bridge then becomes sensitive to pressure.
• Parrot's beak: A bulge above the tip of the nose, because too much cartilage was left on the lower nasal bridge. The profile then resembles a parrot's beak.

Why a hump can become noticeable again after years

Many of my revision patients report that their nose looked good immediately after the first operation. Only one or two years later did steps, edges or a new small hump become visible. This is because the swelling hides irregularities for a long time. Only once it has completely subsided does it show how precisely bone and cartilage were actually worked on.

In my observation, the transition in the keystone area, the point where bone and cartilage meet, was most often given too little attention. If this transition is not shaped evenly, a step develops over time. That is why I check this area several times during the operation.

An article cannot provide a complete list of all risks. The medical informed consent discussion in person is required by law and remains indispensable. There I address your individual situation.

What hump nose correction costs: what it depends on

I deliberately do not quote a flat price for a hump correction. The effort differs considerably from nose to nose. These factors determine it:

• the type and size of the hump and the ratio of bony to cartilaginous part
• whether an osteotomy of the nasal bones is necessary
• whether obstructed breathing is treated at the same time on the nasal septum or turbinates
• whether incisions at the edge of the nostrils are necessary
• whether it is a primary operation or a revision
• whether cartilage from the ear, from a donor or from the rib is needed
• whether you stay in the clinic for one or two nights

Each of these points makes the operation longer or more complex. You will receive a reliable assessment after the examination in the consultation. Whether there is also a medical indication alongside the aesthetic concern, such as obstructed nasal breathing, is something we clarify there as well. You can book your consultation online.

Frequently asked questions about the hump nose

Can a nasal hump be removed without surgery?

No. A nasal hump consists of bone and cartilage, and both can only be removed surgically. With hyaluronic acid I can visually disguise a small hump on a rather delicate nose by filling the areas above and below it. However, the nose becomes slightly larger as a result. For large noses I advise against it.

How long does healing take after hump removal?

The tubes stay in for four to seven days, the external splint for fourteen days. Most people feel ready to be seen in public after two to three weeks and are able to work after about three weeks. Sport is possible again after six to eight weeks. Depending on skin thickness, the final result shows after one to several years.

Does the nose have to be broken to remove a hump?

In most cases, yes. After removal, the nasal bones stand open like a roof without a ridge. So that the nasal bridge does not remain too wide at the top, the lateral nasal bones are divided in a controlled way and brought together in the middle. This osteotomy is an essential step for a harmonious result.

Will there be a visible scar after open rhinoplasty?

With the open technique, a small incision is made on the columella between the nostrils. Once healed, the scar is usually barely visible. All other incisions are inside the nose. In return, I have a direct view of the entire nasal framework during the operation and can work more precisely.

Can a nasal hump grow back after surgery?

A hump does not grow back in the true sense. However, if it is removed incompletely or a step remains at the transition from bone to cartilage, an elevation can become visible again once the swelling has gone down. This often only shows after one to two years. Careful filing and irrigation reduce this risk.

From what age can a hump nose be operated on?

A hump correction only makes sense once the growth of the face is complete. Before that, the nose can still change considerably. When this point is reached varies from person to person and does not depend on age alone. In the consultation I assess whether an operation already makes sense or whether it is better to wait.

Why don't you show before and after photos of a hump nose?

German law on the advertising of medical treatments, the Heilmittelwerbegesetz, prohibits advertising aesthetic surgery with before and after images. In July 2025 the German Federal Court of Justice made clear that this ban also applies to injection treatments, such as nose correction with hyaluronic acid. We comply with this. Instead, in a personal consultation I show you in a 3D simulation how a change could look in your own face. This simulation, however, is not a promise of the result.

Does hump removal improve or worsen breathing?

Removing a hump can narrow the internal nasal valves. That is why I use spreader grafts as a rule, which keep the airway open and stabilise it. If nasal breathing is already obstructed, for example by a deviated septum, it can be treated in the same operation. I clarify this beforehand during the examination.

Conclusion

Correcting a hump nose means far more than shaving down a curve. The hump consists of bone and cartilage, and both require their own steps. After removal an open roof is created that must be closed, otherwise indentations and an overly wide nasal bridge appear years later. Spreader grafts protect breathing and create a calm line. The keystone area decides whether the nasal bridge stays smooth even after the swelling has gone down.

From my work with previously operated noses I know how much depends on these details. That is why I operate open, file the hump down in fine steps, irrigate thoroughly and stabilise the nasal bridge instead of weakening it. Which shape suits your face, whether straight, fine or with a touch of character, is something we work out together.

If you are considering having your hump nose corrected, I will gladly take time for you. You can find out more about my work on the page about rhinoplasty in Frankfurt. I offer consultations in Frankfurt and Zurich, and surgery takes place exclusively at the Berger Klinik in Frankfurt. You can book your personal appointment directly online.

This article is for general information and does not replace a personal medical consultation and informed consent discussion.