Rhinoplasty Without Breaking Nasal Bones?

I've noticed that many prospective patients on the web are particularly worried about the bones and having to "break" them. Fact is, the majority of the work, difficulty, and complications with rhinoplasty tend to be related to the soft-tissue work of the tip and mid-third. The bones are often the least difficult part of the surgery and are not "broken," but rather precisely cut and repositioned. Since the nasal bones are thin, just rasping a large hump, for example, without cutting bone can create what's known as an open-roof deformity.
That said, if there's nothing wrong with the shape and proportions of the bones, then there's no reason to touch them at all. We call this a tip rhinoplasty.

All the best,
--DCP

If the shape of the tip is the only modification, it is possible to perform a tip rhinoplasty or "tip-plasty" without having to surgically break the nasal bones.
"Tip rhinoplasty" can be performed via a closed rhinoplasty or an open rhinoplasty. In closed rhinoplasty, all the incision are placed on the inside of the nose. Open rhinoplasty involves connecting the intranasal incisions with an incision across the column of tissue between the nostrils. Closed rhinoplasty is certainly appropriate for some tip deformities, but many surgeons prefer the open approach to correct major deformities of the tip because the open approach allows direct visualization of the structures.

Yes, it is possible to do a rhinoplasty without "breaking" the bones. However, it is often necessary to make sure the whole nose appears balanced.
For example, if the surgeon narrows the tip significantly, the bones may then appear too wide. The contour of the nose may then be "off," with the bones being wider than the tip. This would not look good.
I have found it is actually rare for someone to have a wide tip but have narrow nasal bones. Thus, fixing the tip and narrowing the bones is often necessary.
To narrow the bones, they must be "broken." However, as one of the other doctors already pointed out, this is not merely a breaking action. This is a very precisely controlled cut along the bone that enables the surgeon to reposition it. In fact, most surgeons will agree that fixing the tip is far more complicated and tricky than fixing the bones.
In summary, it is possible to have a rhinoplasty without the need for "breaking" the bones. It is only done if it is necessary to ensure balance.