Why do I have a hump on my nose (what causes a dorsal hump)?

“I have a hump on my nose.“

This is a concern I hear from patients very frequently. It’s often the very first thing they point out. They feel this “hump” (what we call a “dorsal hump“) throws off their facial balance, especially from the side, and they understandably just want it gone.

I understand completely. But what most people don’t realize is that this hump is often just the “tip of the iceberg.”

A humpy nose isn’t just a cosmetic issue. It’s a structural one. And very often, the same forces that created the hump on the outside also created a problem on the inside—like a deviated septum.

As a surgeon, I see it as my duty to address not just the question you ask (“Can you remove this bump?”) but also the questions you might not know to ask. Let’s cover all of them.

What Causes a Hump on the Nose?

Patients frequently ask, “Why do I have this?” “Is it genetic?” or “Was it caused by an injury?”

The answer is, most commonly, genetics. Just like your eye color, the blueprint for your nasal structure is inherited from your parents. During your development, the bone and cartilage of your nasal bridge simply grew more prominently than the rest of your nose, creating that convex “hump.”

The second most common cause is trauma. If you broke your nose in the past—even a minor injury in childhood you don’t remember—it can heal with a “bony callus.” This healing process can create a new hump or make an existing one more pronounced.

And “Is it normal to have a bump on my nose?” Absolutely. It is an extremely common and normal variation of human anatomy. It is not a medical “problem” unless it bothers you aesthetically or—as I will explain—it is linked to a functional breathing issue.

Non-Surgical Options: Myths vs. Reality

I am often asked, “Can I remove or reduce the hump without surgery?” People are hopeful about quick fixes. Here is the truth:

• “Exercises to fix a humpy nose”: This is a popular search query, but it is biologically impossible. Your hump is made of bone and cartilage, not muscle. You cannot “exercise” or “massage” bone into a new shape. These do not work.
• “How to hide a humpy nose with makeup?”: This is a very effective temporary illusion. “How to contour a hooked nose” involves using makeup (a darker shade on the hump, and a highlighter above and below it) to create the optical illusion of a straighter line. It’s a great skill for photos, but it’s not a structural fix.
• “Non-Surgical Rhinoplasty” (Fillers): This is the only “real” non-surgical option. I can inject hyaluronic acid filler into the ‘dip’ above the hump (at the root of the nose) and sometimes at the tip. This camouflages the hump by making the bridge line straight. However, you must understand the drawbacks:
  1. It’s temporary (lasts 9-18 months).
  2. It makes your nose bigger, not smaller. We are adding volume to “hide” the hump, not removing it.
  3. It does nothing for any internal breathing problems.

What Is the Hump? (And Why We Can’t Just “File it Down”)

First, you need to know what the hump actually is. It’s not just one thing. It’s a “roof” made of two different materials:

• The top part, near your eyes, is Bone.
• The lower part, near your tip, is Cartilage.

You can’t just “file it down” and be done. It’s a complex structure, and when you alter it, you are changing the entire architecture of the nose.

The Connection to Breathing (This is Key)

This brings me to the most important question: “Does hump removal affect breathing or nasal function?”

Yes. Absolutely. It can either make it dramatically better or, if done incorrectly, make it catastrophically worse.

Here’s the part I always check with my endoscope (my internal camera): If you have a visible hump or a crooked bridge, there is a very high chance you also have a deviated septum.

Think of the septum as the central “load-bearing wall” of your nose. If that wall is bent or crooked, the whole “roof” (your bridge) will often grow in a crooked or humped way.

So, while you are worried about the look of the hump, I am worried about the blockage from the septum. You might not even realize how poorly you’re breathing because you’ve lived with it your whole life.

The Surgical Solution: “Septorhinoplasty”

This is why, for me, this surgery is almost always a “Septorhinoplasty.” This one procedure addresses all related issues.

• “Rhino” (Rhinoplasty): Rhinoplasty is the aesthetic part. This is where we address ‘What surgical techniques are used?’ We carefully and precisely lower that “roof” of bone and cartilage to give you the straight, smooth profile you want.
• “Septo” (Septoplasty): This is the functional part. This is where I go inside and straighten that deviated septum, clearing your airway.

Doing one without the other is a half-job. What’s the point of a straight-looking nose if you still can’t breathe through it?

Risks and Complications: What Can Go Wrong?

This brings us to “What are the risks or potential complications?”

The biggest risk, in my opinion, is not bleeding or infection (which are rare) but a functional collapse.

If a surgeon only shaves down the hump and doesn’t know how to properly rebuild the structure, they can cause new breathing problems. When you remove that “roof,” the two side walls of the nose are left un-supported. You must rebuild this internal support (we often use “spreader grafts” from your own septum) so the “walls” are strong.

If you don’t, the nose can slowly pinch inward over time as it heals, causing what we call “nasal valve collapse.” This is a severe breathing obstruction that is very difficult to fix.

This also answers, “What if the hump is only on one side… or the nose looks asymmetric?” An asymmetric hump is almost always a sign of an asymmetric (deviated) septum underneath. The “wall” is crooked, so the “roof” built on top of it is also crooked. The solution is the same: a septorhinoplasty to straighten the entire structure from the inside out.

On Healing and Results…

I need my patients to understand that this surgery is a journey, not an event. The nose is a slow healer. When I take the cast off after a week, you will see the big change—the hump will be gone. But that is not your final nose. It will be swollen.

I always tell my patients, “You will be happy with your nose at 3 months, but you will know your final nose at 12 months.” It truly takes one full year for that last 10-20% of subtle, “puffy” swelling to disappear and for the skin to fully ‘shrink-wrap’ to the new underlying structure. You must be patient with the healing process.

On Cost (UK vs. USA)…

“So, how much will this cost me?”

Look, there is no ‘standard price’ for this procedure, and any surgeon who gives you a flat fee over the phone isn’t being honest. The cost depends entirely on what your nose needs. Is it a simple hump removal? Or is your septum severely deviated, requiring a complex reconstruction?

The fee in a major capital like London or a city like New York will naturally be different from a smaller town. But to give you a realistic ballpark for a full septorhinoplasty by an experienced surgeon in those major markets, you are likely looking at a total cost somewhere in the range of £9,000 to £17,000+ in the UK, or $12,000 to $25,000+ in the USA.