Why aren’t osteotomies required when rasping down a callus post op?

Question

Hello, I have been asking myself this question for the longest time. I saw that some people who get a rhinoplasty can develop a callus post op. This callus can be rasped down with a local anesthesia procedure. Normally when taking down a bump on the nose, osteotomies are done to close the open roof deformity, but why aren’t osteotomies required when rasping down a callus post op? Thank you for your answers.

Eric M. Joseph, MD · Answer

You are correct that rasping a callus would lead to a wider nasal appearance, and that osteotomies are often needed. I hope that this helps. Sincerely, Dr Joseph

Gary M. Horndeski, MD · Answer

If the callus can be rasped down then there is not need for an osteotomy.  An osteotomy can lead to a new callus formation.

Best Wishes,

Gary Horndeski, M.D.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Osteotomies are required when performing dorsal hump reduction in order to prevent an open roof deformity. In my opinion, rasping under local anesthesia does not work well. It will generally look OK for 1 to 2 months and by one year they will be contour irregularities. A much better approach is to do a fascial onlay graft or another technique to smooth the dorsum instead. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Shabnam Ghazizadeh, MD · Answer

Hi @sisitecandy, Osteotomies are only truly required if a significant hump is removed which causes an 'open roof deformity.' This would recreate the desired triangular shape of the nasal bones instead of a trapezoid shape. A small hump would not always require osteomies and same for a callus. Hope that helps! Best of luck, Dr. Ghazizadeh

Mats Hagstrom, MD (license on probation) · Answer

There are no absolute rules in rhinoplasty surgery.
If a significant reduction is done, then it can leave the door on the wide side and for that reason osteotomy may be beneficial.
There is no one way to do this procedure.
It depends on what each patient needs and how the procedure is performed.
 You can certainly rest the nasal bones without infract.
Infracturing is done when infracturing is needed.
Best,
Mats Hagstrom, MD

Why aren’t osteotomies required when rasping down a callus post op?

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Why aren’t osteotomies required when rasping down a callus post op?

Answers (5)

Answer: Rhinoplasty techniques

Answer: Rhinoplasty techniques

Answer: What is required when.

Answer: What is required when.

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Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.