People commonly fear having their nose “broken” during routine cosmetic or reconstructive nasal surgery. First of all, it is not really “breaking”; it is more like “cutting”, so it is much more precise than breaking, and is much less of a big deal than you might think. Secondly, like any maneuver during rhinoplasty, cutting the bone in order to narrow the upper portion of the nose is only performed when necessary. Not everyone needs it.
When does your nose need to be broken during rhinoplasty?
When a hump is removed from the bridge of the nose it results temporarily in a wider, flatter nasal bridge, known as an “open roof”. In order to correct this wide bridge, the bones on either side of the nose are carefully cut and moved together, making the correct shape to the nasal bridge. In other patients, there is no bump but the upper nose is wide and these bony cuts, known as “osteotomies” are performed and the nasal bones are narrowed (infractured).
In patients who have had previous nasal fractures (broken noses) or in patients with crooked noses, similar osteotomies are performed to straighten the nose.
If the bridge of the nose has no bump or if the upper part of the nose does not need narrowing, then no “osteotomies” and no “infracture” are required.
How is the bone “broken”?
When necessary, a small chisel is placed inside the nose and used to cut the bone on each side. Once the osteotomies (bone cuts) have been made, the surgeon places gentle pressure on each side and the bones are moved closer together (infractured).
Will it be more painful?
Having your nose “broken” during rhinoplasty is not painful. The only disadvantage for the patient is that the osteotomies tend to cause bruising. Bruising adds some time, but not pain, to the recovery. Usually the bruising resolves in 7-10 days.
During the recovery period, you will experience swelling, some soreness, and the bruising mentioned above. Dr. Thorne will place a plastic splint on your nose to hold the bones in position and prescribe you some pain medication after the surgery.
You will see the improved shape in your nose as soon as the splint is removed after about 5 days, but the nose, especially the tip, will be swollen. Approximately 2/3 of the swelling will be gone after one month.
If you are thinking of having a rhinoplasty done, it is important to consult a surgeon with years of experience. Dr. Charles Thorne has 30 years of experience in performing plastic surgery in his Park Avenue office. He has also taught and written numerous books about facial aesthetic surgery. So set an appointment with him here. He will be happy to address all your concerns.
Dr. Thorne is the Editor-in-Chief and the author of several chapters in Grabb and Smith's PLASTIC SURGERY, 7th Edition.