Do bones fuse back together after nasal osteotomy?

Question

When a surgeon narrows the nasal bridge with an osteotomy, it seems like there must then be a gap created between the nasal bones and the facial bones. Does the nasal bridge then remain disconnected from the facial bones or do the bones heal back together? If they heal back together how long does that take?

David C. Pearson, MD · Answer

It usually takes about six weeks for the nasal bones to heal back together at which point they are essentially back to original strength. This is fairly similar to how most broken bones heal. It's also why most of us who perform a lot of rhinoplasty surgery will emphasize the importance of avoiding impacts to the nose during those first critical six weeks post-op.All the best,--DCPPearson Facial Plastic Surgery®

Kenneth Hughes, MD · Answer

Hello. Great question. The bones will heal back together within a couple of weeks. Please consult with a board certified plastic surgeon for a detailed surgical plan.

Jay Calvert, MD, FACS · Answer

The answer to this question is simply that the bones NEVER heal to their original state.  Nasal osteotomies heal by fibrous union  - in other words, scar tissue fills in the gap in the bones.  The published data shows that the nose is never as strong after rhinoplasty as it was before rhinoplasty.

Tanya Judge, MD · Answer

Hi,
When we change the position of the nasal bones..usually moving them closer together, we are generally not disconnecting them completely from where they are attached to the facial bones. If done from the outside of the nose, we use a 2mm sharp instrument to make 2mm breaks in the bone leaving connected bone in-between (this is called a greenstick fracture) and then gently adjust the position of the bones.  That leaves some bone and soft tissue to support the structure while it heals and the areas where the bone was broken to grow back over the course of 6 weeks.  Thats why we ask that you not put any pressure on your nose for 6 weeks.  If at 6 weeks you still have some pain of the nasal bones, that means they are not ready to support weight and we simply give more time for the bones to heal in properly.  
Best,
Dr. Tanya Judge

Paul N. Afrooz, MD · Answer

Ostoeomies are essentially very precise and controlled cuts of the bone which free the bones such that they can be repositioned into a more cosmetically-pleasing position.  These osteotomies do heal just like any other bone in the body and achieve almost normal strength by 6-8 weeks following surgery.  Often times after rhinoplasty, patients are advised not to have anything rest on the nose such as glasses.  Part of the reason for this is because the bones are still healing for up to 8 weeks.

William Portuese, MD · Answer

The nasal bones do heal after osteotomies  mostly by fibrous union, not complete bony union. In our practice, we perform medial and lateral osteotomies nasal bones after dorsal hump removal to close the open roof created from the hump removal and narrow  the bridge line.  The nasal bones  are usually pretty well-healed by 6 to 8 weeks after the procedure.

Mehdi Sina, MD · Answer

Hi,The bones can be fully disconnected (but remain in a soft tissue pocket) or partially disconnected. They do fuse back together and by 8 weeks they are almost at the strength before surgery. Best,

Michael Elam, MD (retired) · Answer

Dear Buddon, The nasal bones fuse back together and this generally takes approximately six weeks. Best regards, Michael V. Elam, M.D.

Richard W. Fleming, MD (retired) · Answer

Yes, the nasal bones will fuse after nasal osteotomies just like any broken bone. After about 6 weeks healing is complete.

Do bones fuse back together after nasal osteotomy?

Answers (9)

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