Is it possible to see osteotomy lines on a CT scan months after rhinoplasty? (Photos)

Question

My surgeon was supposed to make changes only to my nose tip but my nasal bones look deviated to the left after primary rhinoplasty. I asked if he made osteotomies because I’m not sure why exactly my nasal bones look deviated but lost trust in him due to him dodging my questions. I have preoperative and 4 month postoperative CT scans of my nose but I can’t identify if any osteotomies were made even though when touched there are significant dents and gaps in my bones that I’m looking forward to fix in my revision. Is it possible that they could not be visible because of them healing seamlessly or quality of the CT scans is low thus altering the image?

Jeffrey H. Spiegel, MD · Answer

There's nothing in these images to say with certainty that osteotomies were done. The surgical operative note should say.  However, osteotomies are often part of rhinoplasty even when the bones are not the focus in order to balance the appearance.  In any case, it may not matter. If you are unhappy you can get a revision to improve the appearance hopefully.

Yasemin Aydinli, MD · Answer

Yes, this is possible. Osteotomy lines often become difficult or impossible to see on a CT scan by four months because the bone heals and remodels, and thin cuts can ossify without leaving a visible trace. Scan quality and slice thickness also matter, so a low resolution study can miss subtle findings. The dents and gaps you feel are more informative than the scan itself, and they can be assessed and addressed during revision planning. A dedicated fine cut CT reviewed by a radiologist may give you more clarity if you need documentation.

Is it possible to see osteotomy lines on a CT scan months after rhinoplasty? (Photos)

Answers (2)

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