The anatomy of the dorsal hump is usually both cartilaginous and bony. The nasal bones and the dorsal septum can both or independently be excessive. Any of these situations can contribute to a dorsal hump.

A wide tip is primarily related to positioning and orientation of the lower lateral cartilages. Dr. Rohrich and colleagues categorized three types of boxy tip relating to a wide intercrural angle, a wide domal arch, or both.¹ Wide or bulbous tips can also result from bifidity of the nasal tip, excess or convex lateral crura, or lower lateral cartilage malposition.

Dorsal hump and wide nasal tip are the two most commonly encountered patient complaints regarding their nose.

On palpation of the dorsum, a dorsal hump can be bony or cartilaginous, or in some instances both.

Palpation of the tip cartilages is important to give information regarding integrity, positioning, and recoil of the lower lateral cartilages.

Although CT imaging can be useful in nasal surgery for airway abnormalities, routine scans are not obtained for patients presenting for correction of dorsal hump and wide nasal tips.

A clear surgical plan should be outlined prior to any rhinoplasty procedure.