Break or Not to Break Nose During Rhinoplasty?

What is the difference between having your nose broken or not during Rhinoplasty?

Doctor Answers 14

Rhinoplasty and Osteotomy

Most commonly the bones are shaved down over the dorsum and the hump is removed. Once this is done the base of the bones have to be broken to move the base of the bones inward to close the nose down into a pyramid.

I would not overly concern your self with the detailed parts of the surgery as if it is necessary it needs to be done.

Orange County Plastic Surgeon
5.0 out of 5 stars 69 reviews

Not always necessary to perform lateral osteotomy in rhinoplasty surgery

Not all rhinoplasty procedures require the breaking of the nasal bones, this is known as a lateral osteotomy. There are several reasons to perform this fracture. If a large nasal hump has been removed it is necessary to perform this controlled fracture in order to close the gap created when the hump was removed. The widest portion of the nose should typically be within a line drawn down from the corner of the eyes. This will narrow the nasal base and create nicer aesthetic lines.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 15 reviews

Will my nose be broken during rhinoplasty?

"Breaking the nose" is a very crude term for something that is occasionally performed during rhinoplasty. The medical term for this is actually called an osteotomy. This is a very controlled cutting of the bone that is performed to narrow the upper portion of the nose.  It is not performed in every rhinoplasty. There are three situations when this usually comes up:
1) narrowing a wide nose
2) after a hump is removed the nose can sometimes be wide and this technique may need to be performed (see attached) and
3) Making a crooked nose straighter. 

Performing an osteotomy does not mean that your recovery will be any different then if it were not performed during your surgery.

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon
4.9 out of 5 stars 41 reviews

Nasal bones are reset when removing a large bump

The osteotomies or re-breaking of the nasal bone is performed to narrow a wide bridge. Once the large hump has been taken off the bridge the osteotomies and re-breaking of the nasal bones have to occur; otherwise, an open roof deformity will result, which will look like a flattop nose. If a small hump is present, these can be simply filed off and re-breaking of the nose will not need to occur.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 121 reviews

Options for rhinoplasty

Breaking the nose is usually done when a large hump is removed from the bridge of the nose or if the nose is too wide. Small humps can be gradually shaved down without the need to break the nose. Although, breaking the nose post-operatively is pretty well tolerated and it can give you a fantastic result. Good luck!

Deends on what is needed

Breaking the nose bones is called "osteotomy" and is done with more or less, a surgical mallet and chisel. The nose contains bone and cartilage components for the skeletal support. Only the bones are addressed this way. Osteotomy is used to narrow the bony part of the nose, and to straighten the bony pyramid. If these maneuvers aren't needed, no osteotomy is performed.


Usually during a rhinoplasty, the bone is shaved down a bit, and this will flatten the dorsum of the nose. The bones are infractured to re-create the pyramid shape of the nasal bones and as a result the bones are a bit narrowed as well. If the dorsum is minimally shaved, then the dorsum is not flattened and infracture is not necessary.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 23 reviews

Breaking nasal bones during rhinoplasty

The two main reasons that your nasal bones would need to be broken during a rhinoplasty are to either narrow the width of the nose or to reconstruct the dorsum after a large hump has been removed ("closing an open roof deformity" in technical terms). Therefore, there are some patients that do not need to have the bones broken as part of their individual procedure, but many do.

Many patients are quite concerned about this part of their rhinoplasty, and fear that it may be significantly uncomfortable, cause a longer recovery, etc. The reality is that there can certainly be more bruising and a bit more discomfort when breaking of the nose, or osteotomies, are required, but if it is necessary to achieve the desired result, both cosmetically and functionally, it needs to be done.

Hope that helps and good luck!

Dr. S

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 140 reviews

Break the nose during rhinoplasty

Osteotomies (breaking the nose) is the essential part for narrowing the bony part of the nose. When a nasal hump is reduced, oseteotomies are needed to narrow the nasal bridge.

If you are getting only the tip worked on, then osteotomies are not needed.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 72 reviews

Rhinoplasty; To "Break or Not to Break?", That is the Question

Hi Mary,

Good question. What is the difference between breaking or not breaking the nose during rhinoplasty? A loud cracking sound with, just kidding.

Most noses require cutting the nasal bones (breaking) to narrow the upper 1/3, and to close the roof of the nose which was uncovered by the removal of the dorsal boney hump.

Some noses do not require cutting of the nasal bones.

Individual noses need to be examined, the goals of the rhinoplasty need to be set, and then the plan to achieve those goals is made. Whether or not the nasal bones are "broken" during surgery will depend upon the balance and harmony of the nose, and what needs to be done to achieve the best result.

The good news is that "breaking" the nose does not add discomfort to rhinoplasty recovery (amazingly).

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.