When removing a hump on the nose, how do you know if this requires an osteotome or if it can be filed down with a rasp?
Hump reduction is commonly a part of rhinoplasty. With smaller humps simple rasps (think nail file only larger) can be used to bring down the bone to a better profile as well as smooth out any irregularities. Larger humps, however, often require osteotomies for reduction.
Osteotomies are precise bony cuts made with oeteotomes (think refined chisels) to both remove the hump directly as well as to narrow the nasal bridge. In addition, osteotomies are often required with severely deviated noses to straighten the bones. This can be associated with more bruising, swelling and discomfort, but typically provides a more dramatic result.
The first step to determining if osteotomies are required for your nasal procedure is to consult with a board certified facial plastic surgeon.