Am I a good candIdate for correctIng an arched nose?

When patients come to see me specifically about an “arched nose,” their complaint is almost always the same. They feel the “bump” on their nose dominates their side view and want a profile that is straight, or perhaps has a very slight, soft curve. 

I understand this completely. It’s a feeling that your nose is out of balance with the rest of your face. But before we can plan the rhinoplasty ,we have to understand what that bump is.

What is an “Arched Nose”?

So what is this “bump”? An “arched nose,” a “Roman nose,” or what we surgeons just call a “dorsal hump” isn’t just a simple shaving job. It’s a complex, 3D structure made of two different materials:

• The top part (near your eyes) is hard Bone.
• The bottom part (near the tip) is firm Cartilage.

To fix an arched nose, you have to successfully and smoothly handle both. This is why a proper rhinoplasty is a surgery of millimeters, demanding true precision. You are re-sculpting the entire roof of the nose.

So, Who is a Good Candidate for This?

The first qualification is simple: you have a dorsal hump, you’re in good health, and you feel that hump is out of balance with your face. You are also realistic: you understand this is a structural, permanent solution, not a “quick fix” with fillers.

But for me, as the surgeon, a “good candidate” means something far more specific. When I’m in a consultation, I’m not just looking at your hump; I’m assessing the materials I have to work with. Your anatomy is what determines the surgical plan.

• Your Skin: This is a critical factor. Is your skin thick or thin? Thin skin is unforgiving; it will show every tiny edge of the new, straight bridge, so the underlying surgical work must be perfect. Thick, oily skin presents a different challenge: it’s harder to see the new definition, and the skin may not “shrink-wrap” down to the new, smaller frame. This means we must build the new bridge with extra strength and definition.
• The Hump Itself: How big is it? Is it mostly bone, mostly cartilage, or an equal mix? A large hump means a large “open roof” (which I’ll explain below), and that requires a more robust reconstructive plan.
• Your Tip and Septum: Your nose doesn’t exist in a vacuum. A high arched nose often exists with a weak or droopy tip. In this case, you are not a good candidate for just “shaving the hump.” We must rebuild the tip at the same time to create balance. This requires cartilage grafts. Do you have a straight septum with enough cartilage to harvest for the “spreader grafts” we will need to rebuild the bridge?

Being a “good candidate” means your goals and your unique anatomy (your skin, your cartilage) line up for a successful, strong, and natural-looking result.

How We Fix a Hump (The Two Main Rhinoplasty Techniques)

The goal is to get a straight, natural-looking bridge. How we get there depends on your specific nose. When I plan the rhinoplasty, I have two main philosophies.

1. The “Traditional” Structural Approach For decades, the standard way was to work from the top. We open the nose and, using very precise tools, shave down the bone and trim the cartilage to create the new, straight line.

This is an excellent, reliable rhinoplasty technique. But there is a crucial step that comes next:

When you remove the “roof” of the hump, you create a flat, “open roof.” To fix this, we must perform “osteotomies”—tiny, controlled fractures on the side of the nasal bones. This allows us to gently bring the bones together to create a new, properly rounded and strong bridge.

2. The “Preservation” Rhinoplasty This is a more modern technique, and for the right patient, it’s a game-changer.

Instead of removing the hump from the top, we go underneath it.

Think of it this way: We remove a tiny, precise “support beam” of cartilage from the septum inside the nose. This creates a space. Then, the entire bridge—with its original, smooth, unbroken bone and cartilage—can be gently “let down” or “pushed down” into the new, lower position.

The “arch” is gone, but we preserved your natural bridge. This often means less swelling, less bruising, and an incredibly natural-looking result.

Here’s the Part Patients Don’t Think About Before Their “Nose Job”

This is where my ENT (Ear, Nose, and Throat) background is so important.

That hump isn’t just for looks; it’s a key structural part of your nose. If a surgeon just removes a large hump without thinking, they can accidentally weaken the “middle vault” of the nose.

What does that mean? It means that a year or two later, the sides of the nose can slowly “pinch” inward, causing a new breathing problem that wasn’t there before.

So, for me, this rhinoplasty isn’t just about removing the hump. It’s about rebuilding and supporting the new, straight bridge. This often means using tiny, invisible cartilage grafts from your septum to make sure the nose is not just straight, but strong and open for breathing.