Osteotomies on the outside of the nose. Will this technique affect my eyes and in what circumstances is this technique used?

I don't necessarily agree with the use of external osteotomies in rhinoplasty, and have never found them necessary as just about anything to the bones needed can be, I find, done from internally.  That being said, I know some of my colleagues utilize them and I have seen undetectable results so I don't think that this is a problem.

The technique that is used for osteotomies is very surgeon specific. I don't use percutaneous osteotomies as I feel that I can accomplish the changes from an osteotomy through an endonasal route, or from the inside of the nose. That being said, I have seen them done on a number of patients and the small 2mm incision that is typically made to perform these heals very well with little evidence of a scar. If done in the right hands, this does not pose any risk to your eyes or vision.

Some surgeons place osteotomies on the outside of the nose through the skin. In our practice, we make all the incisions on the inside of the nose to perform the osteotomies. This avoids any scarring in the skin and gives excellent control to the nasal bones when resetting them inwards. For many examples and more information about osteotomies, please see the link and video below

Performing osteotomies through the external skin is a common technique and if done well there should be little to no scarring. There are times when the surgeon feels he or she has more control over where to fracture the nasal bones by going through the skin and this can often be less traumatic as well since the periosteum (layer of connective tissue that supplies the bones with blood) is not as damaged. Whether a particular surgeon chooses to use this technique has to do with their training and experience as well as the particular situation with that patient.I hope you found this helpful.