Trans cutaneous osteotomy - where do the bone pieces go? (Photo)

Where do the bone pieces go when plastic surgeon does a trans cutaneous rhinoplasty to reduce a hump?

Doctor Answers 5

Transcutaneous osteotomy

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Thanks for your question. Transcutaneous osteotomies are done through tiny incisions directly over where the bone needs to be fractured. You postage-stamp the bone and then it can be moved by using pressure from your fingers. It is a technique that simply allows bone to move. You can't remove bone with this technique. Any hump reduction needs to be done through a hole large enough to remove the hump, either through an open or closed approach. Check out the before and after photo from my site to see an example using a closed approach. Good luck!

College Station Facial Plastic Surgeon

Transcutaneous osteotomy

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This maneuver fractures the nasal bones through a small 2 mm incision on each side of the nose using the same 2 mm osteotome to both pierce the skin and fracture the bone.  The bone is simply "in-fractured" or moved close together to give the dorsal bridge a narrower profile.  Best wishes, Dr. T. 


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The osteotomy separates the nasal bones from the maxillary bone. The bones don't go anywhere but they become loose so they can be moved and positioned where the surgeon wants them. Hope that answers your question.

Jeffrey Jumaily, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

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Trancutaneous osteotomy

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I perform ostetomies through very smalls tab incisions on the side of the nose, but the bone is rasped down and the cartilage is shaved down under direct vision.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Where do bone pieces go when it rains?

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I think you're a bit confused maybe. Or I am. Your photo shows a transcutaneous osteotomy (in fracture usually), which narrows the upper part of the nose from front on. In a hump reduction, regardless of whether it is done via open rhinoplasty or closed rhinoplasty, the excess bone is either rasped off, or sliced off with an osteotome, and generally thrown out with the infectious waste. A transcutaneous osteotomy is not a method of hump removal. An actual appointment with a surgeon can often very quickly clear up a lot of misconceptions and allow you to move on to the more important decisions you're facing. Best wishes.

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