Narrowing of the Wide Nasal Dorsum in the ‘Minimal-Hump’ Nose: A Simplified Universal Approach

The operative procedure frequently used to narrow the nasal pyramid in the context of a regular rhinoplasty is well known to all rhinoplastic surgeons. It consists of hump removal, followed by lateral osteotomies and medialization of the nasal bones. However, narrowing of a wide nasal pyramid, in the absence of an appreciable dorsal hump, as in the case of an ideal dorsal height or a mild hump, presents a different challenge. The present article describes a simplified approach to the 'nasal plateau resection', a technique that allows the creation of an open nasal roof, without hump removal and without compromising dorsal projection. This permits the medialization of the lateral nasal bones and the subsequent narrowing of the wide pyramid, while preserving the height of the nasal dorsum as viewed in profile.