Or is the upper width of them too great therefore do I need to have the bones broken? I like my tip, nasal base width & profile. It's just the width of the bones at the top (not at the base). It's for cosmetic reasons but I also find it difficult to wear sunglassses because of this. If I need the bones broken is it a relatively simple procedure that can be done via a closed rhinoplasty without affecting the shape/size of my original nose? Any advice would be much appreciated. Thanks in advance.
Can I Just Have my Nasal Bones Rasped a 1-2mm to Bring Them in Line with the Rest of my Nose? (photo)
Doctor Answers (11)
Hi there. As always, the definitive answer rests with an in-person consultation. Generally speaking, a nasal hump is reduced via rasping. Hump reduction may lead to the nose looking wide (known medically as an "open roof"). This would necessitate osteotomies ("breaking the nose") to narrow the nose and re-establish nasal harmony. As an analogy, please think of a pyramid. Imagine the top or apex of the pyramid has been removed. From above, the pyramid would then look wide (i.e. "open roof"). It would be necessary to reposition the walls of the pyramid (i.e. osteotomies).
These maneuvers may be accomplished via closed technique (all incisions made within the nose). A precise knowledge of the intranasal anatomy is critical. Select a surgeon who is able to display multiple before and after photos of rhinoplasty patients. Regards, Andy Shah MD
Rasp the nasal bones
The nasal bones can be reduced in height with a rasp, but to narrow them needs an osteotomy ( the bones broken)
The problem with rasping only is that the nose will appear broad and flat and that is a result that I suspect will not meet your expectations. A rhinoplasty is about proportion, so to decrease height often means you need to narrow the nose to maintain proportion.
I hope that is of some help
Can I Just Have my Nasal Bones Rasped a 1-2mm to Bring Them in Line with the Rest of my Nose?
From the photos provided, the nasal bones appear to be separated indicating an "open roof" deformity. In that situation, further rasping isn't the solution. The nasal bones would need to be broken and moved towards the midline.
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Rasping nose and osteotomies
Most nasal rasping will result in an open roof and therefore look flatter and wider. Osteotomies bring the nasal bones medially and improve the dorsal lines.
Rasping the bridge line and osteotomies
Most patients need osteotomies after a hump has been removed. In this particular case, the top of the bridge is quite wide and will become even more wide when only rasping is performed. Osteotomies will be required, and this can be performed with closed rhinoplasty techniques. Please see our closed rhinoplasty photo gallery link below
If you are happy with the tip (cartilage portion) of your nose then it is perfectly reasonable to have your nasal bones adjusted using a closed rhinoplasty technique. Yes, it would be necessary to break the nasal bones (osteotomy) to narrow the dorsum. Rasping by itself will not work.
All the best,
Osteotomy or rasping of nose?
The nasal bridge is a key part of nasal aesthetics. A rasping alone will not be appropriate for your nasal bones, they are too wide.
It should however be possible to correct the bony vault closed. My practice is mainly open rhinoplasty, but your picture demonstrates most likely vault work alone which is possible to do closed.
All the best,
Osteotomies Are Necessary.
When there is a hump or excess fullness on the bridge of the nose, rasping the nasal bones is the treatment. If the hump has a cartilaginous component (they frequently do), this cartilage is also shaved to bring it down to the level of the rasped bone. These maneuvers treat the hump in profile view and can certainly take care of a 1-2mm reduction. Almost always the nasal bones also need to be "reset" using osteotomies (breaking and resetting the bones) into a more narrow position. This makes the front and oblique views of your nose look better. Looking at your photo, the right way to treat your nose would be to reset your bones to reduce their width after any rasping and this will greatly enhance your rhinoplasty result. They are not difficult to do, nor to recover from. Good luck!
Narrowing the Nasal Bridge
On the basis of one limited picture I think you will need to break the bones after narrowing the bridge. The bones are frequently, successfully broken during rhinoplasty surgery without any significant risk using the closed technique. Other parts of your nose do not need to be changed.
Sometimes simple rasping of the bones is always necessary with rhinoplasty.
The picture is inadequate to give a complete response but it looks as though the bony projections might be able to be treated by rasping only. The overall with the nasal base needs to be evaluated to see if this is a possibility.