Is it possible to have rhinoplasty without osteotomy, and how will it fix my nose? (Photo)

To answer your question I would like to address a few misconceptions.1.  Contrary to what most think, it is the tip work not the bony work (break nose) that has created the most "drastic changes" , complications such as nostril collapse, unnatural appearances.2.  The bridge of the nose is part bony and part cartilage.  When too much of the cartilage from the bridge is shaved down, you will get an inverted V-deformity.  Again, its the cartilage work that creates the most risk.3.  It is the bony work that heals the quickest, often within 6 to 12 weeks vs. the tip work, the swelling lasts up to one year.  I think patients become fearful when they hear that their nose has to be broken as they imagine these large bones being cracked.  In reality, the nasal bones are think and small and they are broken very delicately without much trauma when done properly. In your particular situation, you are probably unhappy with your profile when you look from the right side because both your nasal bridge (the bony part) and the tip are over projected.  To get a more pleasing and natural profile, both the bones and the tip would have to be treated.  These days, tip complications are minimized by not removing cartilage, from the tip or cartilagenous bridge, rather, reshape what you have to create more refinement.  Remember, It is the cartilage removal from the tip and bridge  that creates collapse down the road.  The nose can be broken very gently.Good luck,Ran Y. Rubinstein, MD
200 Stony Brook Court, Newburgh, New York
Board Certified Facial Plastic Surgeon (ABFPRS)American Society forLaser Medicine & Surgery (ASLMS)
Clinical Professor New York Presbyterian Hospital
National Education Faculty (physician trainer) for:
Allergan (Botox, Juvederm, Voluma), Galderma
(Scultpra, Restylane, Silk), Cynosure (Cellulaze, Precision Laser Lift)
& Solta (Fraxel, Thermage)Zeltiq( CoolSculpting)

It is possible to do Tip Plasty that reduces the size of a nasal tip without making any major changes. This does not involve osteotomies but only cartilaginous work. It can be done under local anesthesia in the office. The nasal tip has cartilages only and no bone. The cartilages are partially removed and partially weakened. Everything is done from inside the nostrils and there is no incision on the nasal skin. The softening of the nasal cartilages in the tip makes the tip appear smaller in size. RegardsDr. J

 Every time a  moderate or large dorsal hump is removed, osteotomies are mandatory to close the open roof created from the hump removal.  It only takes 1-2 mm of rasping the bridge down to create a flat top nose and  Bridge line, so the osteotomies are required.   An open roof, flat top deformity also occurs when de- projecting the overly projecting nose. It is important to have a very balanced and natural appearing nose.