How Painful Is Osteotomy Rhinoplasty Recovery?

Mild to moderate pain after osteotomy rhinoplasty is usual. This typically is managed with oral pain medications.

An osteotomy rhinoplasty is a surgical procedure of the nose where a nasal bone is divided or removed. Osteotomy rhinoplasty is not a common procedure. In 2018, for every 213,000 nasal repair surgeries (rhinoplasties) performed in the United States, approximately three were osteotomy rhinoplasties. Osteotomy rhinoplasty is generally performed when nasal deformities are present.

Types of rhinoplasties:

• Rhinoplasty, alar cartilage resection
• Rhinoplasty, Asian
• Rhinoplasty, augmentation
• Rhinoplasty, basic closed technique
• Rhinoplasty, basic open technique
• Rhinoplasty, maxillary augmentation
• Rhinoplasty, spreader grafts
• Rhinoplasty, supratip deformity
• Rhinoplasty, tip approaches
• Rhinoplasty, tip surgery
• Rhinoplasty, tripod theory
• Rhinoplasty, turbinate reduction

Detailed history, physical, and lab evaluations are completed prior to the osteotomy rhinoplasty. Before the osteotomy rhinoplasty, a photograph of the patient’s nose is often taken for review during the surgery.

Before the osteotomy rhinoplasty, the patient is asked to avoid:

• Aspirin
• Anti-inflammatory medications:
  • Ibuprofen
  • Naproxen
• Blood-thinning medications or anticoagulants
• Vitamin E
• Fish oil capsules
• Over-the-counter nutritional agents
• Alcohol

During the procedure

• Rhinoplasty is followed by the osteotomy, under general anesthesia.
• A fracture line is made with the osteotome (an instrument used to perform an osteotomy) on both sides, and manual pressure is exerted to fracture the bone.
• After the completion of the osteotomy, all the incisions are closed, and a splint is applied to keep the nose in place.

After the procedure

• The splints will be left for one week.
• A minimal amount of bleeding can be expected.
• Black blue discoloration around the eye due to bruising caused by the osteotomy rhinoplasty may happen that resolves in one to two weeks.
• Strenuous and vigorous activities such as jogging, horseback riding and skiing should be avoided for the first six weeks.

Mild to moderate pain after osteotomy rhinoplasty is usual. This typically is managed with oral pain medications. The patient can expect a reasonable amount of bruising and swelling of the face immediately after the procedure. Natural healing of the bones will take place. Recovery may proceed for up to a year. Surgeons prefer osteotomy rhinoplasty, since the relapse rates of deformities are lower.