Ethnic black rhinoplasty in black femaleRhinoplasty (Surgery of the Nose)

Infractures - Moving the nasal bones and cartilages. Exploring rhinoplasty, nasal surgery, and sculpture of the nose by Dr. Michael Bermant, MD plastic and cosmetic surgery.

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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Infractures - Moving the Nasal Bones and Cartilages in Rhinoplasty Surgery

female black patient before rhinoplasty surgery After rhinoplasty surgery black female

To reduce the width of the nose, the bones and attached cartilages needed to be moved medially (inward). This movement is called "infracture". Notice how the boney parts of the nose are not as wide after surgery.


After Rhinoplasty
2 Weeks


ethnic bone structures for rhinoplasty surgery osteotome bone movement for ethnic rhinoplasty in black female


Bone Cuts (osteostomy)

To move the bones, they must be cut carefully from the surrounding structures (osteotomy). This is done with very sharp chisels that are either introduced from inside the nose or through tiny skin incisions at the sides of the nose. Precise cutting minimizes damage to the nasal lining and postoperative swelling. Heavy sedation or general anesthesia are preferable to avoid the sounds of the chisel and mallet. See and listen to a movie of this part of the rhinoplasty. Because this movie is graphic, you may want to avoid the lowest part of this page. Go to movie.

As the nasal bones move in, they raise the dorsum (top ridge) of the nose. Notice the increase in nasal height. This patient did not have a graft to her nose. The gain was solely from the movement of the bones and the alar wedge / nostril sill resections tip elevation.

Before rhinoplasty in black female patient bone structures in black female patient after rhinoplasty in black female patient


Bone /
cartilage hump

Rhinoplasty 2 Weeks

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Rhinoplasty Nasal Surgery Important Information

Learn more about rhinoplasty surgery of the nose

Open Rhinoplasty - Photographic details during surgery of the Black nose (warning graphic pictures).

Open Rhinoplasty - Pictures of dorsal and tip sculpture during surgery (warning graphic photographs)

Patient Pictures before and after surgery

Rhinoplasty Experiences Discussions, Forum, and Chat

Nasal Obstruction Septoplasty and Other Nose Discussion Groups, Forum, and Chat

rhinoplasty before nose job before before rhinoplasty nose rhinoplasty before septorhinoplasty before rhinoplasty before before rhinoplasty and septoplasty before septorhinoplasty
rhinoplasty after nose job after after rhinoplasty nose rhinoplasty after septorhinoplasty after rhinoplasty after after rhinoplasty and septoplasty after septoplasty - rhinoplasty
nose job before rhinoplasty before rhinoplasty female before before rhinoplasty rhinoplasty before before rhinoplasty before rhinoplasty
nose job after rhinoplasty after rhinoplasty female after after rhinoplasty rhinoplasty after after rhinoplasty after rhinoplasty



This Movie of the removal of a dorsal hump may be too graphical for some viewers.




Rhinoplasty surgery often involves moving bones. This must be done in a precise fashion. No this is not done by leveling a hammer and hoping for a lucky break. Dr.Bermant's hands precisely guide the location of the cut in the bone with the very sharp chisel. The nurse hits the osteotome (chisel) with the mallet (hammer). In this case Dr. Bermant is performing an external osteotomy. The nasal bones are being cut through a very tiny incision on the side of the nose. Other times rhinoplasty osteotomy is done through incisions inside the nose.

Bermant Plastic and Cosmetic Surgery Rhinoplasty nose surgery
A blown up still from the rhinoplasty movie.


The sounds are the major component of this movie. Dr. Bermant uses the sound to determine when the chisel has cut through the bone. We will load a larger version when Internet bandwidth permits. This movie demonstrates moving the nasal bones during rhinoplasty. You are looking at the osteotome (a very sharp chisel that cuts the bone). A mallet (hammer) taps the chisel to apply the force.

It should run without problems if your browser has the QuickTime plug in (available for both Mac and IBM). The file is 200K and should download in about 1 minute at 28.8 modem speed. Play the movie again by clicking on the arrow at the bottom left. Drag the small slider to position to a particular frame.

Get Your QuickTime Movies and Videos Software If you do not have the QuickTime Movie plug in, get it here. If the movies do not work, check that you have the latest version of your video playing software.

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This page last updated on: April 21, 2012

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