Under Eye Incisions Normal for Rhinoplasty?

Question

I had a rhynoplasty and have two incisions under my eyes close to my nose, is this normal? My doctor said those incisions were done to be able to break the nose.

Steven Goldman, MD · Answer

Some surgeons will use small incisions at the top and side of the nose to help break the nose at rhinoplasty. These incisions are typically small (about 2 mm) and not very noticeable. They are more commonly used in patients with thick, strong nasal bones.

Houtan Chaboki, MD · Answer

Hi Seu,

	Yes, external incisions around the bridge of the nose may be used for bone reshaping (osteotomy). These small incisions are under the eye area and generally heal very well. The most common external incision is the one used in "open" rhinoplasty, where the incision is placed between the nostrils. Speak with your rhinoplasty surgeon regarding any concerns you may have. Best of luck.

	Dr. Chaboki

Scott Trimas, MD · Answer

Some physicians use what is referred to as percutaneous osteotomies to narrow the nose and put the bones back into postiion. These are done through small incisions in the skin and typically heal without any problems. I hope this information helps.

Richard H. Tholen, MD, FACS · Answer

Your doctor used these small puncture incisions to insert a tiny chisel-like surgical instrument called an osteotome. As he told you, these were used to allow access to break the nasal bones and create your new nasal shape. While most surgeons who do nasal bone osteotomies during rhinoplasty use internal access to these bones, some prefer the external incision approach, just as some surgeons use "open" rhinoplasty techniques (external incision) and others use "closed" rhinoplasty  techniques (all internal incisions).

	As others have stated, these small incisions under your eyes usually heal just fine; speak with your surgeon if you have any concerns during the healing process, and avoid ultraviolet exposure (tanning booths or sun) to decrease the chances that the scars will darken permanently.

Joseph Mele, MD · Answer

The incisions for rhinoplasty are primarily inside the nostrils (closed technique) and the incisions are often connected with a small incision across the skin between to nostrils (open technique). Small incisions are also occasionally made along the sides of the upper nose (1-2 mm) to facilitate "infracturing" narrowing to width of the nasal bones when seen from the front. These incisions are made to allow a very small osteotome (like a tiny chisel) to be used on the bone as it transitions from facial to nasal bones. They tend to heal quickly and leave minimal scar. So to answer your question, yes, this is normal.

Mehryar (Ray) Taban, MD, FACS · Answer

Yes, these are small incisions used for lateral osteotomy, and they will heal very well.

	Dr Taban

Thomas E. Kaniff, MD, FACS · Answer

Hi Seu -

	Yes, there is an osteotmy technique that uses access through small skin incisions.

	Sincerely,

	Tom Kaniff

Steven Wallach, MD · Answer

These small incisions are probably from external osteotomies which usually heal little to no scarring evident.  I use this approach quite often.

Mark Preston, MD · Answer

If your surgeon did per cutaneous osteotomies to "break" the nose then these incisions are normal and necessary. They are usually quite small and should heal quickly.

Barry L. Eppley, MD, DMD · Answer

One of the necessary steps in many rhinoplasties is to 'break the bones'. While not used in every rhinoplasty, removing a hump and narrowing the width of the upper nose requires the bones to be moved inward or osteotomized. They are cut with an instrument called an osteotome which looks like a very tiny chisel. To get the chisel to cut the nasal bones, the instrument has to be placed next to them. This can be done from small incisions inside the nose or placed at the side of the nose from the outside. You are seeing the typical incisions used for a percutaneous or through the skin nose bone cutting method. These will go on to heal and will not be seen later. This is a perfectly normal and well established rhinoplasty technique.

Under Eye Incisions Normal for Rhinoplasty?

Answers (14)

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