Will my Doctor Break my Nose During a Rhinoplasty?

my greatest fear of a nose job is the doctor snapping my nose. Thats not urban legend is it, that doctors break your nose during nose surgery?

Doctor Answers 68

Reason to break the nasal bones during rhinoplasty

Many people are concerned that they will have their nasal bones fractured during rhinoplasty.  So, why would this need to be done in some cases and not in others? The simple answer is that when taking down a nasal hump, it is important to narrowing the nasal bones in order the close the "open roof" created during hump reduction.  Without this step the nose will appear too wide.  The other general reason is to straighten the nose when it is crooked. When tip work is the only thing that is needed, it is typically unnecessary to break the bones.  Recovery is prolonged a little as of a result and bruising is more common when the bones have to be broken. 

San Diego Facial Plastic Surgeon
4.5 out of 5 stars 107 reviews

Breaking the Nasal Bones

Depending on what is being done to reshape the nose, it may be necessary to break the nasal bones.

This is done with special bone cutting instruments for precision.

Of course, you would be unaware of what is happening during surgery with sedation or anesthesia to allow you to sleep through the entire procedure.

The pain from the breaking of the bones is similar to a very mild headache.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.5 out of 5 stars 27 reviews

To reshape the nose "breaking bones" may be needed

To reshape the nose in many cases the nasal bones and nasal wall may need to be repositioned.  This is accomplished with surgical cutting instruments to make precise cuts to reposition the nose.  It is not severely painful and if needed the surgeon will give the patient some form of pain relief to minimize the discomfort.

Robert Mounsey, MD
Toronto Facial Plastic Surgeon
4.5 out of 5 stars 9 reviews

Rhinoplasty, Narrowing the Nasal Bones or Breaking the Nasal Bones

Rhinoplasty is an art and oftentimes a veriety of techniques are used to get the best aesthetic outocome.

Breaking the bones is not done in all rhinoplasty patients. Often times, reshaping of the bones are performed without breaking the bones by special instruments.

The technique of Osteotomies or controlled narrowing of the nasal bones is common aspect of rhinoplasty procedures. This portion of  the procedure can be fairly painless.

This technique is routinely used to:

  1. Narrow the upper third of the nose
  2. Narrow the nasal bones and improve the aesthetics of the nose after hump reduction
  3. Reducing the width of the upper portion of the nose by repositioning of the bones
  4. Correcting the deviation of the crooked nose or previously broken nose


Nasal Bones have to be reshaped to get the most pleasing result during many types of rhinoplasty procedures.

Hope this was helpful.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 185 reviews

Everyone is afraid of nose breaking during rhinoplasty

There hasn't been a patient that isn't afraid of what happens during rhinoplasty when it comes to breaking the nose.  The image of a doctor breaking the nose with a hammer is far from reality.  In fact, carefully cutting the nasal bones with a fine osteotome, or chisel, during rhinoplasty is a common maneuver with predictable results.  I use a 2 mm wide osteotome (about one-tenth of an inch) and precisely cut the bones where narrowing is needed.  This is just one of over 150 steps in a rhinoplasty, but one that should not create incredible fear. 

Minas Constantinides, MD
Austin Facial Plastic Surgeon
4.0 out of 5 stars 7 reviews

Osteotomies (Surgically Breaking the Nose) and Rhinoplasty

Because each nose is unique, every rhinoplasty should be approached on an individual basis. The need for osteotomies (surgically breaking the nose) will depend on the type of the nasal deformity and the goals for surgery.

The basic premise of surgically breaking the nasal bones (called osteotomies) is that a delicate instrument is used to cut the bones under the skin. The surgeon then repositions them to acheive the desired result.

Osteotomies are performed during rhinoplasty for several reasons.

  • Narrowing a wide bridge (top of nose): One of the most common reasons for surgically breaking the nose is to narrow the bridge after removal of a dorsal hump. When a hump is removed, it leaves a gap along the top of the bridge. This gap needs to be closed so that there is not a depression on the top of the bridge (frequently called an open roof deformity).
  • Narrowing a wide boney base (sides of nose): When the nose is wide where the nasal bones meet the cheek bones, osteotomies can be performed to narrow the width. This usually gives the bridge more definition from the front.
  • Straightening a deviated or crooked nose: If the nasal bones are crooked, they can be repositioned to give the nose a straighter appearance.

Osteotomies usually increase the amount of bruising and swelling, but when performed correctly, can dramatically improve the appearance of the nose. Risks of osteotomies (if not performed correctly) include irregularity of the bone, palpable or visible boney ridges underneath the skin, crookedness of the bridge, and nasal sidewall collapse.

C. Spencer Cochran, MD
Dallas Facial Plastic Surgeon
5.0 out of 5 stars 129 reviews

Rhinoplasty is one of the most difficult facial plastic...

Rhinoplasty is one of the most difficult facial plastic surgical procedures to master. Osteotomies are one of the more difficult maneuvers to understand in rhinoplasty. Having written several papers and chapters on this topic, and having taught this to other surgeons in the cadaver lab during my Facial Plastic Surgery Course, I can tell you these statements are absolutely true.

The indications for breaking the bones of the nose are (not all-inclusive):
•to close the top of the nose when we remove it during dorsal hump reduction (closing an 'open roof')
•to fix a crooked nose (previously broken or otherwise)
•to narrow a wide bony base to the nose

The techniques we use depend on the situation and what's needed.

From the patient's perspective, it's one more reason to choose someone who has a lot of experience in rhinoplasty.

From a recovery standpoint, it increases the likelihood of black eyes after surgery (though it does not mean they always happen, nor does it mean if you have black eyes your bones were definitely broken).

Sam Most, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 56 reviews

Breaking the bones of the nose, or osteotomies, are...

Breaking the bones of the nose, or osteotomies, are oftentimes done in a precise, controlled fashion in order to narrow the width of the bridge of the nose during rhinoplasty.

This maneuver is quite common in rhinoplasty surgery and can produce a nice change or refinement in a nose that looks too big or wide on the face.

Not always necessary

Breaking bones is only necessary if you need to reshape a particular part of the nose, such as to narrow the bridge. It is not aways done as sometimes cartilage or soft tissue manipulation is sufficient to achieve specific aesthetic concerns. In addition, if your nose is broken, it is done very carefully and accurately, so that the break can be controlled. It's not like getting punched in the nose or something like that.

Nasal Infracture Varies From Patient to Patient

Rhinoplasty surgery varies from patient to patient and depends on a variety of factors. Not every patient requires nasal infracture (breaking the nose), but for some patients it’s absolutely essential and without infracture it would be impossible to obtain a good result.

                  Patients undergoing rhinoplasty require a comprehensive evaluation. This requires physical examination and review of pictures from multiple angles. In your case, it’s difficult to make a treatment recommendation without this information.

                  As a general rule it’s usually necessary to perform an infracture when large humps are present or when the nasal bridge is wide. When isolated nasal tip abnormalities are present surgical infracture can usually be avoided.

                  It’s not unusual for patients to be afraid of having their nose broken during surgery. Unfortunately for many patients meeting their aesthetic goals requires infracture. When infracture is performed there may be slightly more swelling and bruising. Patients usually have minimal pain and discomfort following this maneuver.

                  If you’re considering rhinoplasty, consultation with a board certified plastic surgeon is appropriate. This surgeon should be able to help you formulate an appropriate treatment plan.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.