Hello, I had rhinoplasty 6 weeks ago to remove a small hump from my nose. Unfortunately, I am not happy with the result as although my nose looks smooth from profile view, from the front view there are still bumps either side of where the original hump was removed. These bumps are causing my nose to still look like it has a hump from the front view as well as making my nose look wider. Please could you tell me if my surgeon should have made osteotomies and pushed the nasal bones together?
Should the Surgeon Have Made Osteotomies when Removing the Nasal Hump?
Doctor Answers (8)
Do you need osteotomies after hump reduction?
The quick answer is "it depends". A small hump reduction, primarily of the mid third cartilage and just a rasping of the bone with no "open roof deformity" ( that is, the rounded contour of the bone, while reduced in size and projection, is maintained in shape) does not require osteotomies. However, if the width of the nose is too wide from the front, then osteotomies would help narrow the nose from the front, whether you've had a hump reduction or not. Hope this is helpful.
With most hump removals, osteotomies are performed. Ask your surgeon if they were done. Noses tend to be very swollne for months after surgery. Give it time to heal.
Osteotomies are not always required following rhinoplasty with hump reduction
Osteotomies are not always required following rhinoplasty with hump reduction. In some cases, with a small dorsal hump, rasping the bridge of the nose creates a smooth profile without resulting in an "open roof." If the nose does not need to be otherwise narrowed osteotomies are not required in these cases. With regard to your photos, 6 weeks is still early to assess your final result due to swelling. If your concerns persist, return to your surgeon to have your questions answered in person and determine if anything can be done now or later to address your concerns.
Stephen Weber MD, FACS
Web reference: http://weberfacialplasticsurgery.com/rhinoplasty/
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You pictures do not show the need for osteotomies
You have a good results based on the limited views and 6 weeks post surgery. You do not have wide base and do not need the do osteotomies. Give it time to heal .
Rhinoplasty may not require fracture
Though most often when the hump is removed the nose is shaped with osteotomies, or careful cuts in the bone to allow a gentle curve as the bridge is seen straight on, a few individuals may have a very narrow bridge even with hump removal and rasping may shape the nose without a fracture. At six weeks the bridge may still feel full and thick, so wait a month or two more before you judge your result.
Best of luck,
Web reference: http://www.peterejohnsonmd.com/rhinoplasty
Should the bones be broken during a rhinoplasty
From the one view you showed it is impossible to give you an answer. An examination of your bones, and closer look at multiple angles of your preop photos would be required. osteotomies are required when an "open roof" is created after removal of the bump on the dorsum of the nose. If the nose at that point is wide and you can feel the 3 bones, then closing the open roof or osteotomies are indicated.
Your surgeon made that determination based on preop and intra operative examination. small irregularities you do not like on your nose now, can be improved. Return to your surgeon to discuss options such as injections.
Rhinoplasty and Osteotomies
You are six weeks from your surgical procedure so you nose is bound to look wider. Has your doctor told you that he did not perform osteotomies? The photo you posted cannot reveal if osteotomies were performed or not, but they do show swelling around the mid face, as one might predict.
I would try to be more patient before you decide you don't like your result. Usually around three months is a good time for you and your doctor to assess the nose for the first time to discuss possible issues that may exist.
Best of luck.
When removing a dorsal hump, osteotomies are almos always required. They close the open roof created by the osteotomies.
Web reference: http://www.drbray.com
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