Rhinoplasty Without Touching the Bone?

Hello,
If the bones are straight and there is no hump reduction involved, the bones may be left alone. I would need to take a look at your photos to best advise you. Please visit my profile where you will find the contact info for my office. You may email any photos to Lisa, my patient care coordinator. She can also talk to you about costs, which depend on exactly what needs to be performed. Price can range from $10,000-20,000. Thank you for the message.
Dr. Nassif

If the whole nose is long and wide as your question suggests, some reshaping of the bones is usually necessary to achieve a satisfactory aesthetic result. But this is not something that rhinoplasty patients should be concerned with. The goal is always to achieve a natural, safe, and lasting result with the least trauma necessary.
A good surgeon will be able to evaluate what specific techniques are needed to meet the patient's aesthetic goals. If those require reshaping the bones, too--and they often do--then so be it. There are no shortcuts to success.
All the best,
--DCP

 He will evaluate your nose to determine whether or not the bones need to be broken. Often they may not need to be broken because the only part requiring work is the lower half of the nose.

While Rhinoplasty can be performed without dedicated bone work, it is not the most common situation that I encounter. This so called 'finess rhinoplasty' is just a surgery where a patient has little to no profile hump and tip work is all that is required. Other physicians call this a tip-plasty.
Width issues with the nose can be due to skin, bone, or cartilage problems. In the tip, it is usually large cartilages, which can be reduced in size and remodeled with sutures.
If your nose is crooked, as you suggest, then the likelihood of correction without doing bone work is also limited. There are patients with deviated noses that do not require it, but that is a selected minority. There is no way to straighten bone without breaking it.
Your situation seem complicated enough that a formal consultation would likely help you to understand your goals and potential limitations. I would suggest that as the next step for you.

Yes, and no.
Rhinoplasty is not one operation, but many potential operations. A rhinoplasty surgeon develops a unique operating plan for each specific patient. No two patients or surgeries are the same.
Nasal surgery may be done just on the tip of the nose. The cartilage in the tip is reshaping and repositioned, without touching the nasal bone. This nose job surgery is called tiplasty or tip rhinoplasty.
Only after a comprehensive evaluation can a plastic surgeon determine the most appropriate option for you. Best of luck.

Yes there are options to correct the appearance of the nose without touching the bone which we typically call a "tip rhinoplasty". However, it may not be possible to straighten the nose without correcting the bone. Occasionally we do this by performing camouflage procedures such as the non-surgical rhinoplasty but these tend to be temporary.

Every nose operation is customized. Not all noses requiring the bones to be broken.
However, when the nose is WIDE, as you report your nose is, refining the nose WILL require controlled fractures of the side walls and moving the walls in. (Failure to do so , especially when a hump is lowered) will result in a much wider appearing nose.
Dr. P. Aldea

If the nose is quite wide as previously described, narrowing the nasal bones maybe necessary.   This can be determined at a consultation appointment with your surgeon. Standard rhinoplasty costs approximately $6,000, which includes the operating room, anesthesia, and surgeon’s fee.

Each rhinoplasty is unique. In some situations, it may not be necessary to alter the nasal bones. This would depend on your specific nasal shape, airway, and aesthetic goals. The only way to answer this question definitely would be to examine you in person and use photographs/computer imaging to determine what surgical approaches would be used.

Every nose is different, and that is the first thing to remember. No two noses are alike and require different techniques and procedures to get the best result.
In some cases you can correct a deviated nose due to a septal abnormality without osteotomy. This is done by working on the cartilage and using grafts from the nose or ear to camoflage the irregularities and act as butresses to keep the nose straight.
If the crooked appearance is due to a bony deformity as well then this is something to discuss with your plastic surgeon. See several doctors and get opinions. Don't automatically choose one because he tells you what you want to hear. Secaondary rhinoplasties are much more difficult than primary so you want to get the best result the first time.
Steven Schuster MD FACS