My doctor did not perform an osteotomy or place spreader graphs after removing dorsal hump? (Photos)

So, I called my PS office today and received clarification that my surgeon did not in fact perform an osteotomy or place spreader graphs after filing down the hump on my nose during surgery. Now, every day that the swelling goes down, there is a dip on the bridge that keeps showing more and more. I'm so worried that this will only continue to get worse. What reasons could a surgeon have for not closing up that gap? Is there a likely chance of developing saddle nose or Polly beak? Help!

Doctor Answers 5

Dorsal hump and nose

It is difficult to comment without seeing many other views of your nose.  Not all rhinoplasties require osteotomies, and even less require spreader grafts.


New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

I did not have spreader grafts or osteotomies performed with my past rhinoplasty.

Thanks for the question.  How long ago did you have your surgery performed, what did your nose look like before, what did your surgeon tell you about what was needed to give you a good result when he or she saw you pre and postoperativel?  Perhaps you didn't need these procedures performed.  This would be a judgement made at the time of the surgery most likely. I don't always perform these two specific steps in each rhinoplasty that I perform, but this is dictated by the anatomic need and requirement on the overall shape at the time of the surgery.  Always ask your surgeon to give you careful advice and recommendations as you continue to heal properly.
Good luck to you.
Frank Rieger M.D.  Tampa Plastic Surgeon

Open roof after rhinoplasty

You are describing a classic "open roof deformity" after primary rhinoplasty. Although it is early days and you need to wait a year before reoperating, usually a plastic surgeon needs to close the open roof after dorsal hump reduction. This is done with osteotomies or spreader grafts. an inverted V deformity, breathing difficulties or visible uneven dorsum can result if not done during the first surgery. This is the general rule but there are exceptions for example small weak nasal bones.Revision rhinoplasty is required in up to 20 % of patients depending on the experience, skill and technique of the primary surgeon. Good rhinoplasty surgeon's revision rate is

My doctor did not perform an osteotomy or place spreader graphs after removing dorsal hump?

Two major issues!: #1 ONLY a few weeks postop!!!! PLEASE allow 3 months of healing than decide if you have any real issues....#2 Even now the before photos to what you have is a GREAT improvement!!!! You either are in patient for perfect result in a few weeks or you surgeon did not explain the healing phases in rhinoplasty, which takes months. But whatever, you need healing time before considering a revision.

Not every surgery requires what you ask about

Thank you for your question and concern.  Rhinoplasty is truly an art and not every surgery requires spreader grafts or osteotomies.  I don't know how long ago you had your surgery, but if it is less than 6 months I would certainly wait to do anything.  Why not schedule a follow up visit with your plastic surgeon to understand why he/she didn't perform these maneuvers and if you went into surgery with the anticipation of these procedures being done.  It would also hope to show your actual pre-op and better post-op photos.  Good luck, Dr. Schuster in Boca Raton.

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