Creating a Natural Hump Nose After Orthognathic Surgery – Closed Rhinoplasty with Rib Cartilage

Background – Natural Hump Nose After Orthognathic Surgery and Resulting Deformities

About 10 years ago, the patient underwent orthognathic (jaw) surgery. As a result, the nasal structure became weakened and unbalanced. Over time, she developed a deviated nose, a bulbous nasal tip, and a retracted columella. Functional symptoms included nasal obstruction and chronic rhinitis. This case focuses on restoring both function and aesthetics through closed rhinoplasty using rib cartilage—while maintaining a natural hump nose after orthognathic surgery.

Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos

 Nasal Endoscopy Photos , This image shows a deviated nasal septum towards the right and bilateral inferior turbinate hypertrophy.

Patient’s Goal – Preserving a Natural Hump Nose After Orthognathic Surgery

Instead of completely flattening the bridge, the patient requested a natural hump nose to retain a distinctive yet elegant appearance. Her key requests were:

• Straightening the deviated nose

• Refining the wide and bulbous nasal tip

• Enhancing the nasolabial angle by adjusting the columella

• Improving breathing and nasal stability

These are the hump nose reference images desired by the patient.

Surgical Plan – Closed Rhinoplasty with Autologous Rib Cartilage

This case was approached through a fully closed rhinoplasty technique, prioritizing minimal external scarring and rapid recovery.

Key procedures included:

Septal Reconstruction

• Rebuilt the damaged septum using autologous rib cartilage, ensuring long-term durability

• Extended the septum to lengthen the nasal tip and support new structure

Osteotomy & Deviation Correction

• Performed lateral osteotomy to realign the deviated nasal bones

• Corrected overall nasal axis with precise internal maneuvers

Dorsal Hump Design

• Sculpted rib cartilage to match the desired natural dorsal hump

• Balanced the hump with a low, natural radix for a harmonious line

Tip and Columella Refinement

• Slimmed the bulbous nasal tip with internal suture reshaping

• Lowered and repositioned the columella to create a soft, proportional nasolabial angle

Results – Stable, Functional, and Aesthetically Natural Outcome

Before (Left) / Immediately After (Right)

Frontal View:

• Deviation corrected

• More refined nasal tip

• Improved nostril symmetry

Before (Left) / Immediately After (Right)

Side View:

• Natural dorsal hump preserved

• Balanced columella-labial angle

• Improved facial proportions

Before (Left) / Immediately After (Right)

Nostril/Base View:

• Strengthened septum

• Clearer, symmetrical nostrils

Before (Left) / Immediately After (Right)

Expert Insight – When to Choose a Natural Hump Nose After Orthognathic Surgery

Immediately After Surgery: Frontal, Side, and Oblique Side View Photos

Immediately After Surgery: Nostril View Photos

In many cases following orthognathic surgery, the septal cartilage is weakened, and the aesthetic structure becomes compromised.

This case shows how using rib cartilage in a closed approach can:

1. Rebuild long-term support

2. Preserve a patient’s preferred nasal shape

3. Improve both function and facial harmony

By avoiding synthetic implants, we ensured durability and natural integration with the patient’s anatomy.

🔹 At Nose Lab, all surgeries are performed via a fully closed (endonasal) rhinoplasty technique.

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