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Can periosteum damage be avoided during rhinoplasty?

By erio on 25 Nov 2009

I have read that one of the causes for bruising after rhinoplasty is because the covering over the bones are damaged during surgery.

Can you, as a surgeon, lift the periosteum and perform rasping and osteotomy only underneath it? How else do you not damage it?

From the patient's perspective, is there something I can do before or after surgery to help the periosteum not be too damaged or heal well without irregularities?

Comments (2)

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Behrooz Torkian, MD 6 Mar 2010
Hi. The periosteum can be preserved during rhinoplasty by elevating it off of the bones prior to alteration of the nasal dorsum. Althoug there is likely much variation between surgeons, some surgeons routinely approach the nasal dorsum this way - like myself. However, this elevation does not necessarily reduce swelling or bruising. There are many causes of bruising after rhinoplasty and each one can have a high degree of variation between patients, and therefore difficult to control. Dr Torkian.
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Ramtin Kassir, MD 7 Mar 2010
Bruising and swelling in rhinoplasty has a lot to do with whether or not the nasal bones are broken. If so, the chances of bruising are higher. Lifting the periosteum will not cause much bruising if done delicately. You can reduce your bruising in any procedure by taking arnica montana and vitamin C, eating lots of pineapple, and avoiding aspirin products prior to surgery.
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