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How Does a Surgeon Decide if Your Nose Needs to Be Broken or Not for Rhinoplasty?

asked 1 year ago by Saint Paul4491
Latest answer by William Portuese, MD
Question viewed 191 times
Tags: broken nose, re-break

11 answers to How Does a Surgeon Decide if Your Nose Needs to Be Broken or Not for Rhinoplasty?

"Breaking the nasal bones" with rhinoplasty depends on several factors.

First of all, "breaking the bones" seems to give patients an image of some sort of club or baseball-bat-like device used by surgeons to break the nasal bones. Far from this, we use small, sharp tools called osteotomes (like a tiny chisel, often with a lip or "guard" to keep it in exact position) to make slits in the eggshell-thin nasal bones, which allows surgeons to "infracture" or narrow these bones. This narrowing is done for excessively wide upper... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

Rhinoplasty And The Bones

This is probably the most common misconception about rhinoplasty surgery. Most rhinoplasty surgery involves cutting the bones. This is done with specially designed instruments including what the average person would call a chisel. But, just like you wouldn't say that a carpenter breaks wood (at least not a good one!), you shouldn't think of a rhinoplasty surgeon as someone who breaks noses. In short, any rhinoplasty that hopes to make the upper half of the nose... more

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon

www.dr-apo.com

Rhinoplasty never involves "breaking the nose".

Hi. 1) This sounds scary and awful, and has nothing to do with the reality of well done surgery. 2) When the nasal bones are too wide, they are narrowed by a delicate, highly controlled small fracture of the base of the nasal bones. This step allows us to narrow the nose. 3) After a rhinoplasty, you would hardly know whether this step was done or not. If it was done, you will probably have a little more bruising than if it was not. But even... more

George J. Beraka, MD
Manhattan Plastic Surgeon

Rhinoplasty: To Break or Not to Break (the Bones)

Thank you for the question. Based on the frequency with which I am asked this question in consultation, concern over the the idea of "breaking the nasal bones" is almost ubiquitous in patients considering Rhinoplasty. In surgical terms, we refer to this concept as osteotomies, or cuts in the nasal bones, which are performed with very sharp specialized instruments. Osteotomies are utilized most particularly in three circumstances: i) when the nasal bones are crooked, ii)... more

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon

www.drprendiville.com

Whether nasal bones need to be broken for rhinoplasty

Whether nasal bones need to be broken, depends on the size of the dorsal hump being removed. A very small hump can be just rasped and no breaking of the nasal bones is necessary. If there is a large hump that is removed, it will result in a flat top or open roof deformity of the nose, which must be closed with osteotomies.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Rhinoplasty and osteotomies

This is a question that is not easily answered. First, it is important to understand that a rhinoplasty does not involve 'breaking' the bones; rather, there are precise cuts made in the bone so that the bones can be repositioned. If done correctly, it is a very precise and controlled process. Deciding who needs osteotomies is not always straightforward, but in general, if the upper (bony) portion of the nose is crooked, asymmetric, or requires narrowing, then osteotomies are often... more

Ryan Greene, MD, PhD
Fort Lauderdale Facial Plastic Surgeon

Several factors in deciding to perform osteotomies (controlled fractures)

Usually the surgeon will decide to perform carefully controlled microfractures called osteotomies if the bony pyramid is wide or crooked, or otherwise would not be proportionate to the lower cartilaginous pyramid after reshaping this area when performing rhinoplasty. This can and should be discussed as part of the consultation; many times the desired result can be achieved without the need for these "fractures".

Harrison C. Putman III, MD
Peoria Facial Plastic Surgeon

www.specialface.com

"breaking" (?) the nose for rhinoplasty

Rhinoplasty always involves (among other things) moving, removing and repositioning of the nasal bones. This is sometimes referred to by lay people as "breaking" the bone. Actually, it is done delicately with special instruments that alolw accurate sculpting and optimal healing.

Andrew Pichler, MD
Sacramento Facial Plastic Surgeon

facedr.com

Breaking nasal bones in rhinoplasty

The components addressed in an aesthetic rhinoplasty are usually the hump, the tip, and the nasal bones. The goal is to make all three look natural and congruent. In general, the larger the hump, the higher the chance the bones will need to be moved inward to match the new dorsum. Not doing so would produce a flattened and "wide" appearance that would not be pleasing to the eye.

Ricardo Izquierdo, MD
Chicago Plastic Surgeon

www.FaceAndBodyChicago.com

There are many reasons that osteotomies (breaking the nasal bones) might be required

Nasal anatomy is fairly complex and very inter-related. Because of this, rhinoplasty surgery is not simple, and thus is very interesting to those surgeons who enjoy it. For these reasons, there is no simple answer to your question, but I'll give a few scenarios that are easy to understand: If you have a crooked nose and the nasal bones contribute to the nose being crooked, they might need to be broken to be repositioned and straightened. If you have a large hump... more

Michael A. Bogdan, MD
Dallas Plastic Surgeon

How to decide to break the nose during Rhinoplasty.

The decision to break the nasal bones during a Rhinoplasty depend on several factors: 1. Is there a large dorsal bony hump, on the nasal bridge, that needs to be removed. Doing so will create an open roof deformity which must be closed by in-fracturing the nasal bones through breaking them. 2. Are the nasal bones splayed out, or wide, on one or both sides of the nose either naturally or as a result of previous nasal trauma. 3. Have the nasal bones been broken in-completely... more