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What Are The Indications To Break The Bones During A Rhinoplasty?

Revision Rhinoplasty Before and After

A patient at Carolina Facial Plastics before and after undergoing nose surgery.

During a rhinoplasty, there are multiple techniques to aesthetically refine the nose and improve breathing.  The nose is composed of bone and cartilage.  The top hard aspect of the nose is composed of bone and the soft mobile part of the nose below is composed of cartilage.  There are times when the nasal bones are fractured (broken) during the surgery.  Fracturing the nasal bones is not always done during a rhinoplasty, but when it is performed, it can increase the chance of bruising and discomfort after the surgery.  In my facial cosmetic surgery practice in Charlotte, there are 3 main indications of breaking the nasal bones during rhinoplasty.

If a nose has a deviation of the bony aspect of the nose to the left or right, then the bones will need to be fractured.  They are broken in a fashion to re-set the bones in a manner to straighten the nose.  This is common in patients that have had trauma to their nose or who have broken their nose in the past.

Another instance of when the nasal bones are broken is in noses that are wide.  During the fracturing of the bones, they are moved in a position to narrow the bony part of the nose.

The most common indication for breaking the nasal bone is to restore the natural shape of the nose after a hump is removed from the nose.  If you look up at your nose from the floor, it is shaped like a triangle.  When a hump is removed from the nose, it changes the shape of the nose from a triangle to a trapezoid.  The tip of the triangle or the bridge of the nose where the bump was removed is flat.  The flat area is caused by the gap between the nasal bones where the bone was removed during the excision of the nasal hump.  The nasal bone is then broken to bring the nasal bone back together and restore the triangular appearance of the nose.  If the bone is not fractured during a hump removal, then an open roof deformity may occur.

As a rhinoplasty specialist in Charlotte, I will only fracture the nasal bones when it is appropriate.  If the nasal bones are broken, I will inject extra medicine during surgery to help prevent bruising and decrease the discomfort.  If you are undergoing a rhinoplasty in Charlotte, you should ask your surgeon if he thinks your nasal bone will need to be broken and why.

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