Does filing or "rasping" nasal bone at top of bridge, on one side, cause scarring or damage? How about adding cartilage to the other side?
Slightly Crooked Bridge, Does A Rasping Nasal Bone Cause Scarring?
Doctor Answers 2
Bone scarring is minimal with rasping
Any time instruments are placed inside the nose, a small layer of scar tissue forms from the simple elevation of the skin up off the cartilaginous-bony framework. This is very minimal. If done in experienced hands, no damage will occur. The rasping of the nasal bones is all done from the inside of the nostrils. Cartilage grafting can be added to the opposite side if there is depression. A portion of cartilage must be taken from the septum to use as a graft when needed.
Rhinoplasty and crooked nasal bridge and nasal bone rasping
In rhinoplasty surgery there are a number of options to correct a crooked nasal bridge. One can rasp or file down the higher side of the bridge, however, this is limited to small asymmetric defects. If the defect is larger, rasping will result in an open roof deformity (the rasping results in creating a hole in the boney nasal pyramid). If this occurs a formal rhinoplasty may be necessary. This involves lateral osteotomies (cutting the lateral part of the nasal bones) and moving the bones together in the mid line to close the open roof. Whenever the bridge is crooked one needs to also evaluate the nasal septum which may also be crooked or deviated and thus may require a septoplasty to straighten it as well. Other options to correct or mask a crooked nasal bridge include on-lay grafts or silastic implants which will hide the underlying defect, or fillers such as Restylane, Juvederm, or Radiesse which can augment the flatter side.