One of the commonest complaints is the presence of a prominent dorsal hump. This is mainly seen on side or profile view. In previous generations, the fashion was for a small retrousse button nose with a very much lowered nasal dorsum.
Today, a straight or in men a very slightly convexed nose is preferred. Reduction of a dorsal hump will usually require fracturing in of the nasal bone so that the pyramidal shape of the nose can be regained usually resulting in a narrow appearance from frontal view. Large dorsal hump reduction involves associated reduction of the upper lateral cartilages and this necessitates the use of spreader grafts in order to avoid mid-vault collapse which is a recognised complication of rhinoplasty surgery (see Revision Rhinoplasty).