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

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

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.

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

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

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