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Can I Just Have my Nasal Bones Rasped a 1-2mm to Bring Them in Line with the Rest of my Nose? (photo)

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.

Doctor Answers (11)

Rhinoplasty

+2

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


San Antonio Facial Plastic Surgeon

Rasp the nasal bones

+1

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

Jeremy Hunt

Jeremy Hunt, MBBS, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 57 reviews

Can I Just Have my Nasal Bones Rasped a 1-2mm to Bring Them in Line with the Rest of my Nose?

+1

 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.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

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Rasping nose and osteotomies

+1

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.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

Rasping the bridge line and osteotomies

+1

 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

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Closed rhinoplasty

+1

Hello,

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,

 

Simon

Simon Overstall, MBBS, FRACS
Melbourne Plastic Surgeon

Osteotomy or rasping of nose?

+1

Hi there,

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,

Howard Webster

Howard Webster, MBBS, FRACS
Melbourne Plastic Surgeon
5.0 out of 5 stars 52 reviews

Osteotomies Are Necessary.

+1

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!

Randolph Capone, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Narrowing the Nasal Bridge

+1

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. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Sometimes simple rasping of the bones is always necessary with rhinoplasty.

+1

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.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.