Download PDF
CC BY 4.0 · Indian J Plast Surg
DOI: 10.1055/s-0045-1802642
Original Article

Postage Stamp Precision Technique of Dorsal Hump Reduction

Uday Bhat
1   Department of Plastic Surgery, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
,
Amit Peswani 
1   Department of Plastic Surgery, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
,
Ishita Katyal
1   Department of Plastic Surgery, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
,
Anudeep T.C 
2   Department of Plastic and Reconstructive Surgery, A La Mode Esthetique Studio, Mysore, Karnataka, India
,
Mangesh Pawar
1   Department of Plastic Surgery, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
,
Suparna P.N
1   Department of Plastic Surgery, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
,
Richa Goel
1   Department of Plastic Surgery, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
› Author Affiliations
› Further Information
Also available at
  Permissions and Reprints

Abstract

Background The conventional methods of dorsal hump reduction planning and execution are prone to errors. The amount to be lowered is usually subject to surgeon's judgment and errors are possible due to differential skin thickness of envelope.

Objectives We propose a hump reduction technique that includes a method to precisely plan the amount of excision based on real surface measurements and our postage stamp technique of hump reduction.

Materials and Methods A prospective study was done in 25 patients requiring dorsal hump reduction. The planning of hump reduction includes precisely plotting the extent of the hump from fixed landmarks on the skin and recreating these distances on the framework after raising the envelope. In contrast to the traditional continuous bony cut in caudocranial direction, we used serial perforations along the proposed profile line. These postage stamp cuts are made using 2 mm osteotome and are converted into a continuous cut using the double-guarded osteotome.

Results All 20 patients were followed till 1 year. There was no major complication and all patients were satisfied with the appearance.

Conclusion Our technique negates the errors in planning and execution. It also helps in reducing the learning curve associated with the control of osteotome making it beneficial for a novice plastic surgeon. It is particularly useful for small humps, and can be used both in open and closed rhinoplasty making it a very good alternative to conventional hump reduction techniques.

Keywords

rhinoplasty - hump reduction - dorsal Hump

Authors' Contributions

U.B., A.P., I.K., A.T.C., M.P., and S.P.N. performed the surgeries. U.B., A.P., and I.K. wrote the manuscript. A.T.C., M.P., S.P.N., and R.G. reviewed the manuscript.


Ethical Approval

The study was done in adherence to the Declaration of Helsinki protocol. Proper preprocedure consents were taken for surgery, documentation, and research purposes. Data storage was performed in accordance with good clinical practice guidelines.




Publication History

Article published online:
24 March 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Apaydin F. Rhinoplasty in the Middle Eastern nose. Facial Plast Surg Clin North Am 2014; 22 (03) 349-355
    CrossrefPubMedSearch in Google Scholar
  • 2 Zucchini S, Brancatelli S, Piccinato A, Marcuzzo AV, Bianchi M, Tirelli G. Evaluation of surgical outcome in rhinoplasty: a comparison between rasp and osteotome in dorsal hump removal. Ear Nose Throat J 2021; 100 (5_suppl, suppl): 436S-442S
    CrossrefPubMedSearch in Google Scholar
  • 3 Rohrich RJ, Ahmad J. Open technique rhinoplasty. In: Plastic Surgery. 4th ed. Vol. 2. Canada: Elsevier; 2018
    Search in Google Scholar
  • 4 Mark B, Constantian MD. Closed rhinoplasty: current techniques, theory, and applications. In: Mathes SJ. ed. Plastic Surgery. 2nd ed. Vol. 2. Philadelphia: Saunders, Elsevier; 2006. . Part I
    Search in Google Scholar
  • 5 Cerkes N. Concurrent elevation of the upper lateral cartilage perichondrium and nasal bone periosteum for management of dorsum: the perichondro-periosteal flap. Aesthet Surg J 2013; 33 (06) 899-914
    CrossrefPubMedSearch in Google Scholar
  • 6 Barrett DM, Casanueva F, Wang T. Understanding approaches to the dorsal hump. Facial Plast Surg 2017; 33 (02) 125-132
    Thieme ConnectPubMedSearch in Google Scholar
  • 7 Rohrich RJ, Muzaffar AR, Janis JE. Component dorsal hump reduction: the importance of maintaining dorsal aesthetic lines in rhinoplasty. Plast Reconstr Surg 2004; 114 (05) 1298-1308 , discussion 1309–1312
    CrossrefPubMedSearch in Google Scholar
  • 8 Pribitkin EA, Lavasani LS, Shindle C, Greywoode JD. Sonic rhinoplasty: sculpting the nasal dorsum with the ultrasonic bone aspirator. Laryngoscope 2010; 120 (08) 1504-1507
    CrossrefPubMedSearch in Google Scholar