Plastic Surgery 101

Why a doctor often has to break bones when you undergo a nose job

Cosmetic surgeons often have to break bones in your nose when performing a rhinoplasty, or nose job. But breaking the nasal bones do not cause more pain to the patient, Dr. Wolf says.
Cosmetic surgeons often have to break bones in your nose when performing a rhinoplasty, or nose job. But breaking the nasal bones do not cause more pain to the patient, Dr. Wolf says. AP

Q. I’ve been thinking of having my nose done but I’m scared of having my nose broken. Do you always have to break the bones and can I just tell my doctor that I don’t want my nose broken?

A. Do you tell the pilot that you don’t want them to accelerate too much because it makes you nauseous? If you’re going to trust your surgeon, you should not tell him or her how to do the surgery.

Approximately one or two times a year, I will not need to fracture the nose. But in most cases, I have to break the nose.

Here’s why: When someone has a bump on their nose and they want it removed, you’re taking an area of bone and cartilage that comes to a point. When you remove that point, your nose will look wider and you will have an open-roof deformity.

An open roof is caused by removing the top part of the bone and cartilage, resulting in the bone, the septum and the other bone not coming together. This creates an illusion that your nose looks much wider than it originally started.

I have treated many patients who were told that they did not need to have their bones fractured and came back because they looked much worse than they started with.

After 34 years of doing nose surgery, I have found that breaking the nasal bones does not cause more pain to the patient. Swelling may or may not be worse due to the fracture.

When you do choose a surgeon to perform your rhinoplasty, your best bet is to pick someone who does a lot of rhinoplasties. He or she should be doing at least 50 a year, as it takes many noses and many years to become competent and great at it.

You should pick a facial plastic surgeon or plastic surgeon that specializes in nasal surgery. In addition, the surgeon should have experience in intranasal surgery, or surgery of the septum and associated structures.

It is important that your surgeon understand intranasal surgery because it’s hard to build the external part of the nose without understanding the inside of the nose.

And you should interview at least two but no more than three doctors as too many interviews will complicate your decision-making process.

In your consultation, while waiting in the waiting room, listen to what patients are saying and see if they are generally happy or unhappy with their results.

Once you see the doctor, ask to see before and after pictures and see if they provide imaging. Imaging of your nose is a relative standard of care and should be included in your consultation.

This will serve two purposes: It will allow you to see what you’re going to have, and it will allow the doctor to see if they will be able to please you.

And you need to choose a doctor that has the same aesthetics as you do. You may have a successful surgery, but you may not be happy if your aesthetics don’t align.

Email Dr. Wolf at cwolf@miamiplasticsurgery.com

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