Are medially fading osteotomies and high-low-high osteotomies used to thin or widen nose?

Question

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. These are maneuvers which can decrease the nasal mid-vault width. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Semih Yildiz, MD, FEBOPRAS · Answer

High-low-high and medially fading osteotomies are planned fracture lines used to mobilize the nasal bones while protecting important support near the nasal base and radix. They are commonly used to close an open roof, narrow a broad bony vault, or correct deviation, but the name of the cut alone does not determine the final width.

Moving the mobilized bones inward narrows the bony bridge; controlled outward movement can widen it, sometimes with grafts or other structural support to maintain the new position. The appropriate pattern depends on bone shape, thickness, deviation, and the desired dorsal lines. A rhinoplasty surgeon must examine the bony vault and plan the cuts and movement together rather than selecting an osteotomy by name alone.

Eric M. Joseph, MD · Answer

After we remove a bump from somebody’s nose, it naturally becomes wider. That necessitates osteotomy, to close the open roof deformity. Sometimes lateral osteotomy are all that is necessary, however, medial osteotomy may become necessary as well. I do not think this is a suitable way to widen somebody’s nose, since the nasal bones would have a propensity to fall inward, not remain wider after they are fractured. I hope this helps! Sincerely, Dr. Joseph.

Ronald J. Edelson, MD · Answer

I’m not sure about your terminology but the osteotomies  in general are used to narrow the nose. Using them to widen the nose would be highly unusual

Tanveer Janjua, MD · Answer

The low high low osteotomies are used primarily for narrowing the nose but can be used to widen it. Same for medial osteotomies. Although it is more common to use both of these for narrowing. When they are used for widening the nose, the recurrence or failure rate is higher. 
Regards
Dr. Janjua

Are medially fading osteotomies and high-low-high osteotomies used to thin or widen nose?

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