Infractures - Moving the Nasal Bones and Cartilages in Rhinoplasty Surgery
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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. |
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After Rhinoplasty
2 Weeks
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Infracture
Bone Cuts (osteostomy)
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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.
 
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)
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Patient Pictures before and after surgery
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Rhinoplasty Experiences Discussions, Forum, and Chat
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Nasal Obstruction Septoplasty and Other Nose Discussion Groups, Forum, and Chat
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WARNING
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.
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.
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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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