Trading Osteoplasty for Osteotomy in an Attempt to Achieve a Rapid Recovery Rhinoplasty

Abstract

Nasal bone lateral osteotomies are a critical component of open and closed rhinoplasty. Lateral osteotomies represent the most traumatic component of rhinoplasty and contribute to significant edema and ecchymosis in the periorbital region. We believe that lateral osteotomies are often performed more frequently than necessary. The senior author of this article has significantly decreased the number of lateral osteotomies that he performs during rhinoplasty and instead advocates for the use of osteoplasty with a rasp when appropriate to narrow and shape the bony dorsum without forming a wide flat open-roof deformity. This study is a retrospective chart review of 239 patients who underwent rhinoplasty with the senior author. Almost half of the patients (44%) did not undergo osteotomies. The revision rate is less than 1% (2 patients). Avoidance of lateral osteotomies in carefully selected patients can offer a more appealing “rapid recovery rhino,” which is characterized by decreased edema, swelling, and faster recovery time with less limitations on postoperative restrictions.