Nose filing, also called nose rasping, smooths a small hump on the bridge of the nose by shaving the bone and, if needed, the cartilage beneath it. It suits small humps on an otherwise proportionate nose; larger humps or a wide or crooked bridge usually need full rhinoplasty.
- Nose filing (nose rasping) lowers a small hump on the bridge with a fine rasp or powered instrument.
- It suits small humps on a nose that is otherwise in proportion; larger humps need full rhinoplasty.
- When the nasal bones are not moved, bruising and swelling are usually limited.
- Removing too much can flatten the bridge, so the change is planned against the whole profile.
- The result is long-lasting because removed bone does not grow back.
Nose filing, also known as nose rasping or dorsal hump rasping, smooths a small hump on the bridge of the nose. The hump is made of bone in its upper part and cartilage in its lower part; in nose filing the surgeon shaves down the bony part with a fine rasp or a powered instrument and trims the cartilage beneath it if needed, so the profile becomes straighter. It is one of the steps used within rhinoplasty, and on its own it suits a specific group of patients.
Who Nose Filing Suits
Nose filing alone is best suited to people with a small, mainly bony hump on a nose that is otherwise in proportion: the tip is well positioned, the nose is straight and breathing is normal. In these cases lowering the hump by a few millimetres is often all the face needs.
It is not enough when:
- The hump is large. Removing a large hump leaves a gap at the top of the bridge, called an open roof, which makes the bridge look flat and wide from the front. The nasal bones then need to be moved inwards, which is part of full rhinoplasty.
- The nose is large overall, not just humped; see nose reduction surgery.
- The tip droops. A drooping tip can make a hump look bigger, and lowering the hump without supporting the tip can leave the nose unbalanced; see nasal tip aesthetics.
- The nose is crooked or breathing is blocked. Alignment and the septum need to be corrected at the same time; see crooked nose and septorhinoplasty.
How Nose Filing Is Done
The operation is usually done under general anaesthesia, although very limited rasping can sometimes be done under sedation. It is most often performed through incisions inside the nostrils. The skin over the bridge is lifted just enough to reach the hump, the bony part is smoothed with a rasp, and the cartilage below is trimmed so the line is even from top to bottom.
Powered instruments, including ultrasonic (piezo) devices, allow bone to be shaped in very small, controlled steps and can reduce trauma to the surrounding soft tissue. Whether hand rasps or powered instruments are used, the aim is the same: a smooth bridge that sits at the right height for the profile. The operation usually takes about an hour, and a small splint or tape is placed on the bridge.
Recovery
When the nasal bones are not moved, bruising and swelling are usually much milder than after full rhinoplasty and may be limited to the area around the bridge. The splint or tape is typically removed after about a week, and many people return to work within a week to ten days. Heavy glasses are usually kept off the bridge for a few weeks; see glasses after rhinoplasty.
The bridge looks straighter as soon as the splint comes off, and the remaining swelling settles over the following weeks and months. For a fuller timeline of what to expect, see rhinoplasty recovery.
Limits and Risks
The main risk of nose filing is removing too much. An over-lowered bridge can look scooped or flat and is more difficult to correct than a small hump that was left in place, so the change is planned against the whole profile, including the tip and the chin. Other risks include small irregularities that can be felt or seen in thin skin, persistent swelling, slight asymmetry, infection and, rarely, the need for a later touch-up. If a small open roof is created, it may need closing to prevent a wide-looking bridge.
When nose filing has already been done and the result needs correcting, the planning is that of a revision operation; see revision nose surgery.
Nose Filing Frequently Asked Questions
Is nose filing the same as nose rasping?
Yes. Nose filing, nose rasping and dorsal hump rasping describe the same step: smoothing the bony part of a small hump with a fine surgical rasp or a powered instrument. It is one of the techniques used within rhinoplasty.
Are the results permanent?
Bone that has been removed does not grow back, so the change to the bridge is long-lasting. The rest of the nose continues to age naturally with the face.
Can a hump be removed without surgery?
No. Filler can disguise a small hump by building up the areas above and below it so the profile looks straighter, but the nose does not become smaller and the effect is temporary. See non-surgical nose job.
What is the ideal line for the bridge?
A common guide is to imagine a straight line from the root of the nose to the tip. In many women a bridge sitting very slightly below this line looks natural, while in many men a straight bridge along the line suits the face better. These are guides, not rules; the right line depends on the whole profile.
How old do you need to be?
The nose should have finished growing, which is usually in the mid-to-late teens. Earlier surgery is only considered in special circumstances after assessment.
References
- Rhinoplasty — American Society of Plastic Surgeons
- Rhinoplasty — British Association of Aesthetic Plastic Surgeons
Professor Şükrü Yazar, Consultant Plastic, Reconstructive and Aesthetic Surgeon, sees patients for nose filing and rhinoplasty consultations at his practice in Nişantaşı, Istanbul.
The information here is for guidance only and does not replace examination, diagnosis or treatment.
