Q: I am an Asian patient. I like my radix but my bridge is generally very wide and widens at the end. Surgeons keep suggesting I get osteotomies to narrow my nasal bones if I want a narrower tip. Is that something that needs to be done, in addition to augmentation? What are the risks of osteotomies? Is there a possibility they could actually make my tip appear more bulbous without modifications, much like altering a hump can make a nasal tip become wider?
A: In Asian rhinoplasty especially, careful consideration of the orientation of the nasal bones and the aesthetic goals of the patient are critical for achieving a successful result. At times, the horizontal orientation of the bones may preclude significant narrowing with osteotomies alone – and significant augmentation of the bridge is required to change its appearance.
Often with significant augmentation osteotomies will not be needed to create a more attractive, defined and narrow bridge. The primary risks of osteotomies involve asymmetries or irregularities along the osteotomy sites if the fractures are not performed precisely.
In-person examination and consultation by an Asian rhinoplasty specialist will help you more accurately the pros and cons of having osteotomies performed.