Open roof

An open roof deformity happens when a nasal hump is removed but the bones are not brought back together. After the bump is shaved down, the bridge can look too wide. A small gap between the bones may show as a line, groove, or open strip along the top of the nose.

This problem usually occurs when osteotomies, the controlled cuts used to move the nasal bones, are skipped or too conservative. It can also appear after previous surgery or trauma. Once the hump is gone, the space is easier to see and the bridge may no longer flow smoothly from the forehead to the tip.

To correct an open roof, the surgeon repositions the nasal bones to close the gap and narrow the upper bridge. This can include precise osteotomies and, when needed, spreader grafts or dorsal onlay grafts to support the middle vault and improve the bridge shape. As swelling settles, the nose should look smoother and more natural.

Open roof correction is often part of revision rhinoplasty. In Beverly Hills, Dr. Richard Zoumalan evaluates the nasal structure, reshapes or repositions the bones, and closes any visible gaps to create a balanced bridge that fits the nasal tip and facial features.