Video 2.4: Thinning the Osteotomy Line with Osteoplasty in Thick Nasal Bones

What this video shows

Patients with thick nasal bones are at risk of unexpected, uncontrolled fractures during osteotomy. Video 2.4 shows the manoeuvre recommended in the book for these cases: the planned osteotomy line is thinned with osteoplasty first, so that the osteotomy later runs exactly where the surgeon wants it and the bone breaks in a controlled way.

This is one of the small but decisive preparation steps of the Reshaping stage that make the closed atraumatic technique predictable, and it is an example of using power tools to reduce the risk of complications rather than to replace surgical judgement.

Key points

• Indication: thick nasal bones with a high risk of uncontrolled fracture.

• The osteotomy line is thinned with a power rasp or burr before the osteotomy.

• Result: a controlled, predictable osteotomy without additional fractures.

In the book: Chapter 2 – Closed Atraumatic Rhinoplasty, section 2.2.5 Reshaping, p. 15 of Rhinoplasty in Practice: An Algorithmic Approach to Modern Surgical Techniques (CRC Press, 2021). About the book and all companion videos.

Surgeon: Prof. Dr. Suleyman Tas, plastic, reconstructive and aesthetic surgeon, Istanbul. This video is part of the surgeon-training material of the book; patients considering rhinoplasty in Istanbul can use it to understand the techniques used at Prof. Dr. Suleyman Tas Clinic.