Is the nose bone broken during open/closed Rhinoplasty?

Hello! Thank you for your question.As far as I can understand from your question.According due your says you might have a bulbous tip and it can be correct with rhinoplasty surgery.If you can provide photos with better lighting, from the side of your face and 1 meter away I would be able to make a proper evaluation.It would be more convenient to decide with face-to-face consultation. Best regards!

Hi @sweet_lavendar! Excellent question. A rhinoplasty in my opinion is one of the most difficult procedures to perform. The skill, artistry, and technique of the surgeon is very important for outcome. In my practice, I utilize piezosurgery. Piezosurgery is a more gentle technique that allows for greater precision. Less bruising and swelling is common with Piezosurgery. In a typical rhinoplasty, a hammer and chisel technique is performed leading to more inadvertent fractures. I hope this was helpful!

Yes, the nasal bones are broken in a controlled fashion during rhinoplasty if necessary.
This is a very important concept for patients to understand before undergoing rhinoplasty. In rhinoplasty, the skin is lifted up in the cartilage and bone is sculpted. The skin is then placed back down. No skin is removed in this procedure, although sometimes if there is excess thickness it can be conservatively thinned. As a result, we rely on the skin‘s ability to contract to the new shape of the nose during the healing process. Thus, depending on the patient’s starting skin thickness, is important not to reduce the size of the nose too much otherwise the nose will lose definition and form. Think of this as if you lost a significant amount of weight but did not buy smaller clothing. It would look like you were wearing oversized shirt.
If the issue is thick skin rather than cartilage, it’s important to understand that you can only get so much of a result if you undergo rhinoplasty and may not be able to achieve sharp definition.

In my practice I prefer open technique called Piezo where we use a special device that uses ultrasonic waves to shape the bone instead of old fashion style where the bone is hammer and chiseled.

Nasal bones and skin during rhinoplasty: during a rhinoplasty, if there is a dorsal hump of bone it is rasped which means it is filed down. The bridge is then narrowed by cutting the bones on each side where they meet the face and moving them in. This is what is meant by “breaking“ the bones. The bones are not actually broken, they are cut and moved in a controlled way. The skin is not cut during rhinoplasty. The underlying skeletal framework is reduced ,or in some cases, rarely built up. When it is reduced the skin then has to contract to the smaller skeletal size, Which it usually does quite well. In some cases steroid injection to the area of the tip and the supratip above it may help that process

To answer your first question, we make little cuts in the nasal bones to remove bony hump and also to narrow your nose. The lower part of your nose is made out of skin soft tissue envelope and underlying cartilage. There are no bones in your tip. We usually reshape the underlying cartilage and bone and do not remove extra skin. If you have thick skin above the tip of your nose, it is hard to remove it, but it could be managed with steroid injections.

Hi there! Breaking the nasal bones can occur during open or closed rhinoplasty. It’s most often done to create narrowness on the front view or to fix a crooked nose. As for extra skin being removed, that depends on the maneuver performed. Most often, the tip is moved and sutured into a new position thus negating the need for skin removal. Hope that helps.

Yes, there are cuts in the nasal bones known as osteotomies which are necessary after a dorsal hump removal to close the open roof deformity created from the hump removal itself. Osteotomy's are an integral part of a rhinoplasty to narrow the upper two thirds the entire bridge line. No skin removal is ever performed during the rhinoplasty procedure, since that would give a visible scar present. Thick skin cannot be changed, and it's treated with steroid shots to manage the excess swelling that occurs after the surgery

Hi and welcome to our forum!
There are different types of rhinoplasty. The tip rhinoplasty corrects nasal tip deformities and does not involve breaking the nasal bones. A septoplasty corrects a crooked nasal septum and does not involve the nasal bones.
However, if the nasal bridge is too high, too wide, or crooked, fracturing the nasal bones during closed or open rhinoplasty will enable the surgeon to straighten, narrow, and lower the bridge.
Without photos, I cannot comment upon your loose nasal skin.
Visit a board certified plastic surgeon for evaluation and discussion.
Best wishes...