Nasal Bone Osteotomy - What Can I Expect With This Revision?

I had a rihnoplasty 3 months ago. Now, there is an open roof on my nose bridge. If I use osteotomy to close the roof of my nose bridge, how much higher and narrower would my nose be after the revision surgery? How the osteotomy is usually performed? Will it break my nose? Will it cause any new problems to my nose's function? Ex.difficult to breath, etc? Thanks a lot!

Doctor Answers 5

Rhinoplasty may be required

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Christina Z:

An "open roof" may require revision rhinoplasty.  If you really have the "open roof," meaning that:

  •    The two nasal bones do not meet in the middle and
  •    There is a soft connection between the two,

then you may have no choice but to have a revision rhinoplasty.  Yes, at revision rhinoplasty, typically, osteotomies (cutting the bone) are done on each side to run the nasal bones closer to each and close the opening in the roof.

Yes, it is a "break of the nose."  But, it is not likely to cause problems with your nose's function.  The repositioned nasal bones are a long way away from the part of the nose where air flow traverses. 

I would certainly reconsult with your surgeon because if, in fact, this is to be done, the timing is important.

The three month point is still a bit early to consider revision rhinoplasty.  Typically, six to nine months may be required, depending on the findings and the doctor's experience dealing with a similar situation. 

Good luck.

Robert Kotler, MD, FACS
Facial Plastic Surgeon

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 90 reviews

Osteotomies with Nasal Revision Surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Osteotomies, which are used to break the nasal bones at their junction with the cheek bones, are done in rhinoplasty surgery after a hump removal to avoid an open roof deformity.  This procedure will make the nasal bridge narrower but not higher. This maneuver could compromise breathing depending on your anatomy, but discuss this with your surgeon.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Open roof deformity

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This is difficult to answer without photos. Osteotomy is a routine manuever in most rhinoplasties. Some doctors try to avoid it in order to give their patients less bruising and quicker recovery but sometimes this is of no value if the result isn't great. Having said that going back and doing it after several months is one of the easier revision maneuvers and should produce a nice resut for you.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Open roof deformity repair, what to expect

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is unfortunate that you had rhinoplasty 3 months ago and now need osteotomies.  It is important to wait a year before undergoing revision nasal surgery.  Osteotomies are made in both the medial and lateral positions of the nasal bones to narrow and close the open roof deformity.  This involves breaking the nasal bones.  It should not create any further problems to your nose’s function or breathing issues.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Nasal Bone Osteotomy - What Can I Expect With This Revision?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

 Yes, osteotomy means breaking the bone during a Rhinoplasty.  This procedure will break the nasal bones, along their base, allowing one or both to meet in the midline thus closing the open roof deformity.  As far as all the other questions, that are very specific to your particular nose, there's no way to answer these as there are no pictures to evaluate.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.