If You Have a Dorsal Hump That is Reduced Would You Require Osteotomies?

asked 7 months ago by 1kewlkid
Latest answer by William Portuese, MD
Question viewed 172 times
Tags: osteotomy

I know if you have a nasal hump you would normally require osteotomies too narrow the nose and correct the gap that would be formed. But if your happy with the width of your nose and wish for it to be wider, not narrower, is there something else that can be done to fill in the rooftop deformity like a graft? Instead of an osteotomy to make it narrower?

9 answers to If You Have a Dorsal Hump That is Reduced Would You Require Osteotomies?

Osteotomies after Nasal Dorsal Hump Removal

Depending on the size of the dorsal hump that is removed, osteotomies are usually done to close the open roof. Grafts of cartilage and fascia could be placed to close the open roof, but this will probably result in a flat dorsum if the bones are not moved.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

When osteotomies are required.

The reason that osteotomies are performed after the hump has been removed is to close the open roof deformity. The open roof deformity must be closed with osteotomies and not cartilage grafting. Simply adding a cartilage graft to the bridge line of the nose will result in a square flat-topped nose with poor angles and definition. It would be counterproductive to what was just removed.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Osteotomies are not necessarily required

In most cases, with significant take down of the dorsal hump, osteotomies are indicated to prevent an open-roof deformity. However, in certain cases, such as yours, it may be possible to achieve this with just rasping.

Jeffrey Epstein MD, FACS
Miami Facial Plastic Surgeon

www.plasticsurgeryoftheface.com

If You Have a Dorsal Hump That is Reduced Would You Require Osteotomies?

Yes, of course. There are two ways to deal with the gap created by removing a dorsal hump during Rhinoplasty. The more common method is to perform Lateral or Intermediate (I prefer Lateral) osteotomies t bring the nasal bones towards the midline closing the gap. The other method that's typically used, when the nasal bines lack sufficient height to meet in the midline, would be placement of a graft along the nasal bridge. I prefer using straight, silastic dorsal... more

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Trends in dorsal rhinoplasty

Traditionally the side bones are cut (broken) to allow the top to converge the close the "open roof" after the top of the A is taken off. The newer trends are to do less and if a small bit of bridge is removed and the angles of the sides are appropriate no lateral osteotomies may be needed. I try to do only what is needed to acheive a natural nose.

Glenn M. Davis, MD
Raleigh-Durham Plastic Surgeon

Osteotomy

Traditional rhinoplasty teaches that osteotomies are requited to close the roof that has been opened by removing the hump or top of the bridgr.Dorsal grafts could be tried but, I thinh they would leave you with a flat brige. In cosmetic procedures your surgeon has to do the best he can with what the patient brings him to work with

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

Dorsal hump reduction in rhinoplasty

When you remove a dorsal hump it is like removing the top of A-framed house. The top becomes broader and flatter hence the term open roof. If the hump is very small the resulting open roof will be small so you do not need to do any additional procedure to the bridge. We close the larger open roofs by cutting into the bone (osteotomies) at the outer bases of the A. That allows the side walls of the nose to be tipped in at the top or moved as a unit towards the midline thereby closing the open... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

Dorsal Hump and Open Roof Deformity

Hi, Very good question. This is difficult to answer without seeing your particular nose. You can remedy the open roof deformity by placing a gortex graft, fascia or crushed cartilage. It just differs from patient to patient. Best, DrS,

Oleh Slupchynskyj, MD
New York Facial Plastic Surgeon

www.facechange.org

Maneuvers in Rhinoplasty depend on the desired result.

You have a pretty good understanding of the problem! As you lower the hump, several things happen depending on how much it is reduced: (Everyone's anatomy varies, but I'll add "mm" to make the example more clear.) 1mm - hump is reduced, dorsum intact 3mm - hump further reduced, dorsum slightly wider and intact (normally, the nose is shaped like a pyramid, so as the height gets shorter, the top platform becomes wider) 5mm - height further... more