Are osteotomies necessary for a dorsal hump removal and/or safe?

It will all depend of how big is the hump and how much reduction of nose height is needed. In other words, if small hump is present, it can be removed with surgical file or burr without osteotomies. However, removal of larger hump will leave deformity of the nose called "open roof" (removing a hump is like removing top of the roof from house), which needs to be corrected using lateral osteotomies to create smooth, uniform dorsum of the nose. Lateral osteotomies will also decrease width of the nose when needed. There is no extra pain involved with osteomoties, bruising and swelling may be slightly increased, but in the interest of good, predictable and stable result lateral osteotomies should be performed whenever needed. In person consultation with a board certified plastic or ENT surgeon with good reputation in  rhinoplasty is recommended. 

Removal of a dorsal hump leads to widening of someone's nasal appearance on front view, since the nasal bridge may be likened to an A-Frame roof. Osteotomies are typically necessary to narrow the nose after hump removal to "close the open-roof deformity". Hope this helps. Dr Joseph

Lateral osteotomies are necessary to prevent an open roof deformity (flattening of the top of your nose) after a dorsal hump removal.  Please refer to my previous answer on rhinoplasty for further details.Best, 
Mark K Markarian, MD, MSPH, FACS

Harvard-trained Board Certified Aesthetic Plastic Surgeon

Osteotomies are almost always needed with hump removal. Otherwise the nose will be too wide and flat. A lot of u students are freaked out by the idea of breaking the bones but it is necessary and done in a very precise and controlled manner.

Hello and thank you for your question.  After reducing a dorsal hump, it is necessary to perform osteotomies in order to prevent an open roof deformity.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon.  If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon. Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

Hello and thank you for you question and sharing your photos. Osteotomies are done to close the 'open roof', created by removing the top of nasal bones, or to narrow the bony dorsum. Osteotomies are standard part of most rhinoplasty procedures and are safe. Best wishes and good luck,

Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon

The amount of hump removed determines whether you need osteotomies.  When a hump is removed the bridge of the nose becomes wider - like lowering the roof of a house. The bridge also becomes flatter.  In most cases, unless the bump was small, the bones need to be broken to bring them together.  This is called closing the open roof.  Even if cartilage is preserved between the bones so that the roof is not open, the bridge may still be too wide and need to be narrowed by breaking them to bring them together.

The question answer is rely on your  original anatomy. If your nose bridge is narrow and main component is cartilage , lateral osteotomies are not mandatory.  if open roof deformity occurs after dorsal hump removing or shaping you need lateral osteotomies. 

Hi and again welcome to our forum!
If a hump deformity is small and shaving does not violate full thickness bone, hump shaving is possible. If full thickness bone is removed, there will be an "open roof deformity", associated with a wide flat nasal bridge, requiring osteotomies bilaterally at the base of the bridge to close the roof. This can be determined after examination by a board certified plastic surgeon. 
Over 200,000 rhinoplasties are performed all over the country every year in the US. It is a safe procedure, safer than driving a car. 
Best wishes...