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Rasping the Nasal Bones or Go for the Typical Rhino (Lateral and Medial Osteotomies)? (photo)

asked 5 months ago by RJason
Latest answer by Richard W. Fleming, MD
Question viewed 505 times
Tags: crooked, broken nose, options, osteotomy, rasp, recommendation

Hello,I had my nose broken 7 months ago that left me with a crookedness that I 'm pretty sure its in the bony section.My doctor said that i may choose if I want the "smaller" surgery which involves only rasping the tip of the bone (she didn't mention anything about the cartilage) and off course my nose wont get any straighter but it will look better,or the "bigger" surgery witch involves osteotomies. What do you think about the first ? Is it possible ? And what about the cartilage ?

12 answers to Rasping the Nasal Bones or Go for the Typical Rhino (Lateral and Medial Osteotomies)? (photo)

+1

Rasping of the Nasal Bones

As best I can tell with the pictures submitted, you have deviation of both the bone and cartilage of your nose following the trauma. After thorough evaluation by an experienced rhinoplasty surgeon who explains all your alternatives, you can decide what changes you want to make. If you'll be satisfied reducing the nose without making it straight, that is what you should do. You do have a lot of options. But remember, if you don't want osteotomies, the amount of hump removal is limited. more
Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

+1

Rasping the Nasal Bones or Go for the Typical Rhino (Lateral and Medial Osteotomies)?

I have performed Rhinoplasty for well over 20 years and from the photos the nasal bones appear crooked and deviated. The best option for straightening these out is to perform osteotomies during the Rhinoplasty IMHO. Rasping the bone is limited to corrections just a mm or so due to the thickness of the nasa bones (perhaps 3-4 mm's thick). This amount of correction, in your case, does not appear adequate. In addition, if the nasal hump is removed, an open... more
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon
+1

After an injury, partial rhinoplasty rarely succeeds.

Dear Jason: In my military and civilian experience with a lot of broken noses, I can tell you that, typically, there is usually more wrong than just a couple of bumps. If the nose is crooked, there is a good chance that the septum is deviated. You did not mention anything about breathing problems. Do you have them? If the middle or lower portion of the nose is crooked, then it is probably not just a matter of the two bumps causing the crooked appearance... more
Robert Kotler, MD

Beverly Hills Facial Plastic Surgeon
+1

Large Nasal Humps Need Osteotomies And Rasping

I think you will find that the simpler approach of rasping will leave you disappointed with your type of nose. To get an acceptable result, you need a complete approach to your dorsum including osteotomies and rasping. Rasping of the nasal bones is a good approach for a really small nasal hump that is largely bone. Your dorsum poses a bigger problem that warrants a more comprehensive approach.
Barry L. Eppley, MD, DMD

Indianapolis Plastic Surgeon

www.eppleyplasticsurgery.com

+1

Rhinoplasty

You will probably need both rasping and osteotomies to get the nose to look good. If you jsut rasp you run the risk of having a very flat wide nose. But, it is difficult to say without an exam.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Polish or Complete Nasal Bone Correction

From your photos, it appears that osteotomies would be better for your overall correction. Polishing the bony irregularities may improve some issues, but will not completely straighten your nose. In the end, it is better to correct the underlying structure, rather than camouflage the issue, as long as the correction is a predictable one. Osteotomies in the setting of nasal trauma are reasonably predictable and will help to improve your function as well. It will also more completely... more
Richard W. Westreich, MD

Manhattan Facial Plastic Surgeon
+1

Minimal nose surgery seldom works well.

Hi. Just going by your pictures, I don't think you will have a good result with just rasping. You may need a spreader graft on the left. In any case, recovery from a "full" rhinoplasty is not bad. see video
George J. Beraka, MD

Manhattan Plastic Surgeon
+1

Rasping a Nose Bump VS a FULL Nose Surgery

It all depends on the look you wish to have at the end of the road. Unlike like threatening conditions, a nose job is NOT an operation you "MUST" have but an operation you "WANT" to have. Small operations commonly produce small or temporary results. For example, the nasal deformity may be hidden temporarily with a long lasting filler. It will not really fix the problem but rapidly APPEAR to correct it for a year or so. The blow to the nose literally shited... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Rhinoplasty and osteotomies

Of course, your exact surgical plan will need to be determined by the in-office exam. Given that, I perform a large amount of revision rhinoplasties. One of the most common causes for revision is inadequate treatment of the nasal dorsum. Almost certainly, you will need osteotomies. Simply shaving will not take care of your bump. Good luck.
David Alessi, MD

Beverly Hills Facial Plastic Surgeon
+1

Rasping the bump

You probably won't be happy with the result with rasping alone. If you are going to have surgery then get it done without compromise the first time.
Michael L. Schwartz, MD

West Palm Beach Plastic Surgeon

www.palmbeachface.com

+1

How to treat bump on nose

Rasping is good for small bumps. For larger bumps usually the osteotomies are need to make sure that the bridge is not too flast or irregular. You should let your surgeon guide you as to what would give you the best result. I can't imagine the cost would really be any different. You will probably be a bit more bruised witht he osteotomies though.
Ronald Schuster, MD

Baltimore Plastic Surgeon
+1

When does a nose need osteotomies?

I think that you would benefit from osteotomies to fully correct the bump seen on the upper nose. it is hard to know for sure, since the pictures submitted can't give enough information. My guess is that if you just had rasping you would probably be left with is called an "open roof deformity." Imagine a triangle (which is the shape of your nose in cross section). If you rasp down the triangle from the top, quickly you will get a scenario... more
Michael Bowman, MD

Montgomery Facial Plastic Surgeon

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