Can a Lateral Osteotomy Be Reversed?

Question

During my primary surgery the doctor removed too much of a dorsal hump. There is some pain on the boney bridge area when I push on it and feels bumpy and irregular. He performed a lateral osteotomy without using spreader grafts and now my nose looks sunken in at the bone region and to thin. It also feels like the nasal bones are really really short. What is causing this and can this be corrected with a revision?

Thomas A. Lamperti, MD · Answer

From the one photo you posted you appear to have collapse of the upper lateral cartilage. This is a common finding after dorsal hump removal, especially if a prophylactic spreader graft isn't placed.

	Fortunately, this is something can can be addressed with revision rhinoplasty surgery. I would suggest you visit with a revision rhinoplasty specialist to examine your nose and give a full assessment of your options.

William Portuese, MD · Answer

It is very difficult to reverse a lateral osteotomy.  The osteotomies can be reversed, however, you may end up with more of a flat top or square top nose known as an open roof deformity.  The best option is to perform medial osteotomies to open up the nasal dorsum and place extended spreader grafts in them to improve the width of the inverted V and pinched upper lateral cartilages.  This gives much better definition in dorsal aesthetic lines and reduces that pinched-in appearance.

Michael L. Schwartz, MD · Answer

You don't give a timeframe for your surgery and your pictures are limited but do suggest some midvault collapse. This can be corrected with spreader grafts and if needed osteotomy and onlay grafts as well. Talk to your surgeon or see someone with extensive revision experience.

Steven Wallach, MD · Answer

Hard to say without an exam but it may be that you have midvault collapse.  You did not give  a time frame for when your surgery took place.

Samir Shureih, MD · Answer

Your pictures show depression at the upper lateral cartillage where it meets the nasal bone. Possible seperation of the upper lateral cartillage. The bony pyramid seems ok.

	Correction of seperated upper lateral cartillage is difficult.

	Talk with your surgeon about your concerns.

Can a Lateral Osteotomy Be Reversed?

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Can a Lateral Osteotomy Be Reversed?

Answers (7)

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Everything you need to know about Revision Rhinoplasty

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