Questions & Answers The Surgical Experience About Anaesthesia 

I would like done a closed procedure to reverse osteotomy on right side.

Your questions answered by our surgeon, Lucian Ion, FRCS(Plast)

Asked on 24 August 2013


I have seen some very good results of your cosmetic nose work, however my issue is beyond cosmetic, although my nose looks reasonable, it is too prominent with dorsum projected above the size of base nasal bones, and the base itself is perfect.

Prior surgeon did closed, which was fine, but instead of the requested "make right mid dorsum wider" he just did an osteotomy and made it narrower, coincidentally I now suffer chronic sinusitis and looking for sinus surgery. But this won't deal with blockage as I believe catarrh build up (now so bad) caused by narrow right side passage.

What I would like done is another closed procedure to reverse osteotomy on right side only and then fix, then place spreader graft for mid dorsum, whilst lowering bridge at end of tip (no tip work needed).

Could you do this, or do you only do open surgery and do you do many grafts?


Modern rhinoplasty surgery typically involves cartilage grafting, and it is also a routine aspect of my work involving nose reshaping.

From what you describe, I would however be looking at an open intervention, which can also be combined with sinus surgery carried out by an ENT colleague.

Spreader grafts are indeed used by some surgeons through a closed approach, but I believe that it is more frequent to use them in combination with the open approach.

Typically, I tend to use computer imaging and simulation as part of the consultation, to identify the characteristics of the external shape changes, and translate them into a surgical management plan. This helps me to understand the patient's requirements more accurately, and advise regarding feasibility and technique.

Lucian Ion Cosmetic Surgeon Mr Lucian Ion FRCS(Plast)
129 Harley Street

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