When Osteotomy is Done to Narrow Nasal Bones, Could the Bones Shift Back and Move?

Question

How long it takes for the bone to heal and stabalize, inorder not to "spring back" to its pre-op position?

Houtan Chaboki, MD · Answer

Yes, nasal bones can potentially move after rhinoplasty. Cosmetic nose surgery typically involves an osteotomy, where the nasal bones are cut. One may think of an osteotomy as a controlled "broken nose". Any potential movement usually occurs within the first couple weeks after rhinoplasty. Therefore, be careful and avoid contact sports or activity where the nose may be hit. Generally, the nasal bones will fuse and become stable 6 weeks after rhinoplasty.

	Your plastic surgeon will help guide you during your recovery process. Best of luck.

	Dr. Chaboki

Sirius K. Yoo, MD · Answer

The nasal bones certainly can move after osteotomies and is probably the most important reason not to bump your nose after rhinoplasty.  Sometimes that bones are only "greenstick fractured" and not particularly mobile.  Other times, the fracture is clean and they can be quite mobile for a couple weeks and capable to movement with light trauma up to 6 weeks.

Rod J. Rohrich, MD · Answer

Often a rhinoplasty does not require osteotomies. If it does, it is used to 1. close an open roof nasal base or 2. refine the dorsum. If done through an external percutaneous approach it can be carefully controlled as it does not spring back to the pre-operative position.

Toby Mayer, MD · Answer

Nasal bone healing after osteotomy takes only 2-3 weeks to be relatively stable if the osteotomies were complete and therefore, they don't spring back.

Michael L. Schwartz, MD · Answer

Nasal bones are pretty set 2-3 weeks after osteotomy with complete fusion at 6 weeks.  Complete osteotomies will not migrate. Incomplete ones may shift during healing.

Francis R. Palmer, III, MD (retired) · Answer

Yes, when the bones are broken and become mobile, there's always a chance that one or both, nasal bones, will shift somewhere along the length of the bone (front or back). IMHO, the bones are the most susceptible during the first month post Rhinoplasty. This is why I instruct all my Rhinoplasty patients to sleep on a U shaped pillow and avoid any nasal contact for 1 month following their Rhinoplasty. I should add that significant shifts, in the nasal bones, are quite rare. When they do occur, the bone(s) will need to be re-broken at 6 months post op.

Richard W. Fleming, MD (retired) · Answer

Nasal bones are relatively stable 2-3 weeks after a rhinoplasty with nasal bone osteotomies. I tell my patients to avoid nasal trauma for 6 weeks after their surgery. If there is a green-stick fracture (an incomplete fracture of the nasal bones) with the osteotomies the bones can spring back to their original position. This is very rare, but can occur immediately after the cast is removed.

When Osteotomy is Done to Narrow Nasal Bones, Could the Bones Shift Back and Move?

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