Will my doctor break my nose during a rhinoplasty?

Osteotomies (term used for breaking and repositioning of nasal bones in rhinoplasty) is actually one of the more simple maneuvers in rhinoplasty and does not necessarily correlate to an increase in pain although it does cause more bruising.

The nose will not need to be broken if you are having rhinoplasty to:

• Make subtle changes to the tip
• Make subtle changes to the bridge
• Reshape a wide and flat nose (African, Southeast Asian, or Latin American noses)

The nose will likely need to be broken if you are having rhinoplasty to:

• Make dramatic changes to the bridge (for example remove a large hump)
• Narrow the nose significantly
• Correct a broken nose or an asymmetric nose

For more information visit http://www.seattlerhinoplasty.com

In most but not all rhinoplasties a surgeon does make some very controlled cuts in the nasal bones and narrow them to correspond with the narrowing of the middle third of the nose and the tip.  A cast is then applied across the bridge to hold the new nasal bones in the new shape. 

Rhinoplasty is one of the most difficult facial plastic surgical procedures to master. Osteotomies are one of the more difficult maneuvers to understand in rhinoplasty. Having written several papers and chapters on this topic, and having taught this to other surgeons in the cadaver lab during my Facial Plastic Surgery Course, I can tell you these statements are absolutely true.

The indications for breaking the bones of the nose are (not all-inclusive):
•to close the top of the nose when we remove it during dorsal hump reduction (closing an 'open roof')
•to fix a crooked nose (previously broken or otherwise)
•to narrow a wide bony base to the nose

The techniques we use depend on the situation and what's needed.

From the patient's perspective, it's one more reason to choose someone who has a lot of experience in rhinoplasty.

From a recovery standpoint, it increases the likelihood of black eyes after surgery (though it does not mean they always happen, nor does it mean if you have black eyes your bones were definitely broken).