Lateral osteotomies

Cuts in the bone made with an osteotome (similar to a chisel) to create small fracture to allow the nasal bones to move. This is used to narrow a nose and/or straighten it.

Lateral osteotomies are controlled cuts made along the sides of the nasal bones so the bones can be moved into a new position. They are commonly used when the upper portion of the nose is wide, crooked, or left with an open space after a dorsal hump has been reduced. By mobilizing the bones, the surgeon can narrow the bony bridge, improve alignment, or create smoother lines from the front view.

The cuts may be made from inside the nose or through small external punctures, depending on the technique and the shape of the nasal bones. An osteotome, which is a fine surgical chisel, or a powered or ultrasonic instrument may be used. The planned path is based on bone thickness, nasal width, facial proportions, and the direction the bones need to move.

Osteotomies are not required in every rhinoplasty. When they are used, precision is important because aggressive narrowing can create asymmetry, irregular edges, or a nasal airway that feels too tight. Bruising and swelling around the eyes may occur after the bones are moved, and the final contour becomes clearer as healing progresses. The goal is a controlled repositioning rather than simply breaking the nose.

For patients considering rhinoplasty in Beverly Hills, understanding lateral osteotomies can help explain how the bony bridge is narrowed or straightened. Dr. Richard Zoumalan evaluates the width, alignment, and shape of the nasal bones to determine whether osteotomies are needed and which approach may create the most balanced result.