Dislike upper part of nose - do I need an osteotomy? (photos)

Question

I am good with my nose width, but it bother me my front view because of my upper nose. Do I need an osteotomy?

Muhammed Fatih Evcimik, MD · Answer

Yes you need osteotomy because you have a thick skin and a little bit changing upper part is good for you

Eric M. Joseph, MD · Answer

Based on your photo, you appear to have a wide nasal appearance involving your bridge tip and nostrils. If you are looking to achieve a narrowing of the upper part of your nose, osteotomies would certainly be necessary during rhinoplasty surgery. Hope this is helpful! Sincerely, Dr Joseph

William Portuese, MD · Answer

Yes indeed, you will require both medial and lateral osteotomies placed in the nasal bones in order to narrow the upper two thirds of the nose.

Ronald J. Edelson, MD · Answer

Your bridge is quite wide. If your want it narrowed an osteotomy is definitely needed. There is no other way to narrow your nose

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.From the photo you provided here is the evaluation I can make:First of all you have very thick skin. Your nose is big and wide, your tip is very bulbous and there is no definition in the tip part.I recommend you a rhinoplasty surgery, you will most probably need rib cartilage reconstruction to reshape the nasal bridge and give more definition especially to the tip.
Best regards!

Randal Haworth, MD, FACS · Answer

It looks like you would be a great candidate for an osteotomy.

Of course, an “in person” exam is necessary.

I hope this helps,
best of luck !

Bulent Cigsar, MD · Answer

Thank you for sharing your photo. Based on this frontal view alone, it isn’t possible to determine whether an osteotomy would be necessary, but the answer is not necessarily.
Osteotomies are performed to reposition the nasal bones when they are too wide, asymmetric, or when the bony vault needs to be closed after significant dorsal reduction. They are not performed routinely in every rhinoplasty.
Since you mention that you are happy with the width of your nose, the focus should first be on identifying exactly what is bothering you in the upper third. In some patients, the concern is related to the contour of the nasal bridge, subtle asymmetry, or the way light reflects from the nasal bones rather than their actual width.
If the bony vault is already well proportioned, an osteotomy may not be necessary. However, if modifying the dorsum would leave an open roof deformity or if there is underlying bony asymmetry, carefully planned osteotomies may still be recommended to achieve the most balanced result.
The decision should be based on your anatomy rather than a routine surgical step. A detailed examination&mdash;including frontal, profile, and basal views, along with palpation of the nasal bones&mdash;is essential before determining the appropriate approach. The goal is to improve harmony while preserving both structural support and nasal function.

Robert Ciardullo, MD · Answer

The width of your nose: in the picture you show, you appear to have a wide bridge and tip. if you chose to have a more narrow nose in the front view it would typically involve an osteotomy for the bridge and a tip plasty for the lower portion of the nose.

Milan Doshi, MS, MCh · Answer

Thank you, Champagnew  for your question and photographs. Our evaluation is incomplete without personal examination to give the most appropriate answer. Despite that to answer your query, an osteotomy will certainly help you to reduce the width of the upper & middle third of your nose. As an adjunct, we suggest undergoing a complete rhinoplasty to provide better tip sharpening and projection.
Please consult a board-certified plastic surgeon near you and discuss this in detail. Wish you an alluring look

Robert Singer, MD · Answer

The simple answer is yes you would benefit from an osteotomy. Every nose is different and unique to that individual. If the appearance of your nose concerns you enough to do something about it, it can be improved with a natural artistically performed rhinoplasty. What would be the best option and exact procedure would depend on an in person examination (not just an online consultation) and discussion about desired outcome. Excellent results can be achieved with either a closed or open technique.

Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you exactly what to do and how technically to do it based on limited photos without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of the operative procedure would not be in your best interest. Natural appearing results need to be individualized and what is appropriate for one patient is not necessarily the best for someone else. I would suggest that you find a surgeon with extensive rhinoplasty experience certified by the American Board of Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, M.D., FACS

La Jolla, California

Dislike upper part of nose - do I need an osteotomy? (photos)

Answers (11)

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