Moving the nasal bones usually requires an osteotomy or cut in the nasal bones using a special osteotome or bone cutting device. When osteotomy is performed, patients usually will experience black and blue discoloration around their eyes and this may last for several weeks. Because of the extensive undermining of tissues with all types of rhinoplasty procedures, the blood supply of the skin can be compromised. For this reason these procedures are usually not performed in smokers. Occasionally, surgery on the nasal dorsum involves adding tissue and this can be the patient’s own tissue or some type of artificial material. Another aspect of rhinoplasty surgery involves whether the nasal bones, fractured or manipulated.
Oftentimes, rhinoplasty procedures are categorized as either open or closed. An open rhinoplasty procedure involves an incision across the columella which is the thin strip of skin that extends from the tip of your nose to your upper lip. This small incision allows complete exposure of the nasal tip cartilages for suturing and shaping the nasal tip. The tip cartilages can be manipulated to some degree without an open approach and this is called a closed rhinoplasty because the incisions are all hidden within the nostrils. It is important for you to discuss what options may be most beneficial to you with your plastic surgeon based upon your anatomy as well as your goals and expectations.