title: Understanding Approaches to the Dorsal Hump.
abstract: Dorsal hump reduction is a central component of western aesthetic rhinoplasty. Surgical success begins with knowledge of aesthetic ideals and accurate preoperative analysis. Knowledge of the patient's distortion from aesthetic ideals informs approach, technique, and instrument selection. Both endonasal and external approaches are suitable for dorsal hump reduction, though the latter affords more versatility when other surgical modifications are necessary. The main techniques consist of en bloc, Skoog, and component resection. Each has their distinct advantage, though a surgeon's comfort level with each should impact technique selection. Completion of the dorsal reduction often leaves a defect that must be reconstructed. Failure to anticipate the potential long-term sequelae and appropriately manage the dorsal defect can lead to a poor result and patient dissatisfaction.
authors.affiliation: Duke Department of Surgery, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Dane M
authors.initials: DM
authors.lastname: Barrett
authors.affiliation: Department of Otolaryngology, San Vicente de Arauco Hospital, Concepcion, Chile.
authors.forename: Fernando
authors.initials: F
authors.lastname: Casanueva
authors.affiliation: Department of Facial Plastic & Reconstructive Surgery, Oregon Health & Science University, Portland, Oregon.
authors.forename: Tom
authors.initials: T
authors.lastname: Wang
mesh_terms: D004954:Esthetics; D006801:Humans; D009666:Nose / Q000033:anatomy & histology*; D009667:Nose Deformities, Acquired / Q000209:etiology / Q000517:prevention & control*; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods; D010347:Patient Care Planning; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D057234:Preoperative Period; D012225:Rhinoplasty / Q000009:adverse effects / Q000379:methods*