Laboratory Studies

Every patient must undergo an appropriate and complete medical history and physical examination prior to rhinoplasty/osteotomy. The following laboratory tests should be included:

CBC
Urinalysis
Electrolytes
Electrocardiogram (for men >40 y and women >50 y, unless a history of hypertension, stroke, arrhythmia, diabetes, or smoking, or any other concerning reason, is present)
Pregnancy test in women of childbearing age
Human immunodeficiency virus (HIV), hepatitis B, and hepatitis C testing

Imaging Studies

Obtain a chest radiograph when none has been performed for more than 1 year, if the patient has a history of smoking or prior disease or if one is indicated by age.

Treatment & Management

ASPS National Clearinghouse of Plastic Surgery Procedural Statistics. 2018 Plastic Surgery Statistics Report. American Society of Plastic Surgeons. Available at https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-full-report-2018.pdf. Accessed: Aug 21, 2019.
Oneal RM, Izenberg PH, Schlesinger J. Surgical anatomy of the nose. Daniel RK, ed. Rhinoplasty. 1993. 27.
Goodman WS, Gilbert RW. The anatomy of external rhinoplasty. Otolaryngol Clin North Am. 1987 Nov. 20(4):641-52. [QxMD MEDLINE Link].
Wayne I. Osteotomies in rhinoplasty surgery. Curr Opin Otolaryngol Head Neck Surg. 2013 Aug. 21(4):379-83. [QxMD MEDLINE Link].
Chen JX, Kozin ED, Dedmon MM, Lee LN. Teaching and practice patterns of lateral osteotomies for rhinoplasty. Am J Otolaryngol. 2017 Jul - Aug. 38 (4):498-500. [QxMD MEDLINE Link].
van Loon B, van Heerbeek N, Maal TJ, et al. Postoperative volume increase of facial soft tissue after percutaneous versus endonasal osteotomy technique in rhinoplasty using 3D stereophotogrammetry. Rhinology. 2011 Mar. 49(1):121-6. [QxMD MEDLINE Link].
Varedi P, Shirani G, Bohluli B, Besharati R, Keyhan SO. A simplified approach to the external lateral nasal osteotomy: a technical note. J Oral Maxillofac Surg. 2013 Aug. 71(8):1435-8. [QxMD MEDLINE Link].
Ghassemi A, Riediger D, Hölzle F, Gerressen M. The intraoral approach to lateral osteotomy: the role of a diamond burr. Aesthetic Plast Surg. 2013 Feb. 37(1):135-8. [QxMD MEDLINE Link].
Varedi P, Bohluli B. Do the Size and Extension of the External Nasal Splint Have an Effect on the Osteotomy, Brow Lines, and Long-Term Results of Rhinoplasty: A Prospective Randomized Controlled Trial of 2 Methods. J Oral Maxillofac Surg. 2015 Sep. 73 (9):1843.e1-9. [QxMD MEDLINE Link].
Tsikopoulos A, Tsikopoulos K, Doxani C, et al. Piezoelectric or Conventional Osteotomy in Rhinoplasty? A Systematic Review and Meta-Analysis of Clinical Outcomes. ORL J Otorhinolaryngol Relat Spec. 2020. 82 (4):216-34. [QxMD MEDLINE Link].
Al Abduwani J, Singh A. Impact of osteotomies and structural grafts in the management of severe twisted or deviated nasal deformity: a critical analysis of 179 patients with open rhinoplasty. Am J Otolaryngol. 2015 Mar-Apr. 36 (2):210-6. [QxMD MEDLINE Link].
Simsek G, Demirtas E. Comparison of surgical outcomes and patient satisfaction after 2 different rhinoplasty techniques. J Craniofac Surg. 2014 Jul. 25 (4):1284-6. [QxMD MEDLINE Link].
Jeong JY, Ha Y, Kim S, Yang HJ, Oh SH. Availability and Safety of Osteotomy in Esthetic Rhinoplasty of East Asian Patients. Ann Plast Surg. 2018 Aug. 81 (2):141-5. [QxMD MEDLINE Link].

Media Gallery

Medial osteotomy being performed during rhinoplasty.
Percutaneous lateral osteotomy.
Lateral osteotomy via piriform aperture.
Nasal bones as seen in skeleton.
Another view of nasal bones.
Nasal bones with outline of medial and lateral osteotomies.

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Author

John A Grossman, MD Clinical Instructor of Plastic Surgery, University of Colorado Health Sciences Center; Private Practice, Plastic and Reconstructive Surgery

John A Grossman, MD is a member of the following medical societies: American Burn Association, American Medical Association, American Society for Aesthetic Plastic Surgery, American Society for Laser Medicine and Surgery, American Society of Plastic Surgeons, Colorado Medical Society, Lipoplasty Society of North America, Pan-Pacific Surgical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Linda Li, MD, FACS Plastic and Reconstructive Surgery (Private Practice)

Linda Li, MD, FACS is a member of the following medical societies: American Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

George Peck, MD

George Peck, MD is a member of the following medical societies: American Society for Aesthetic Plastic Surgery

Disclosure: Nothing to disclose.

Chief Editor

Mark S Granick, MD, FACS Professor of Surgery, Division of Plastic Surgery, Rutgers New Jersey Medical School; Professor of Surgery, Rutgers Robert Wood Johnson Medical School; Medical Director, University Hospital Wound Care Center

Mark S Granick, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American College of Surgeons, American Society of Plastic Surgeons, New Jersey Society of Plastic Surgeons, Northeastern Society of Plastic Surgeons, Phi Beta Kappa, Wound Healing Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: PolarityTE; Misonix<br/>Serve(d) as a speaker or a member of a speakers bureau for: Misonix, PolarityTE<br/>Received income in an amount equal to or greater than $250 from: Misonix, PolarityTE.

Additional Contributors

Frederick J Menick, MD Clinical Associate Professor, Department of Surgery, Division of Plastic Surgery, University of Arizona College of Medicine; Facial and Nasal Reconstructive Surgeon, Tucson, Arizona

Frederick J Menick, MD is a member of the following medical societies: American Society for Aesthetic Plastic Surgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Canadian Society of Plastic Surgeons

Disclosure: receive royalities as author of textbook aesthetic nasal reconstruction for: aesthetic nasal reconstruction.com.

Osteotomy Rhinoplasty Workup

Laboratory Studies

Imaging Studies

References

Tables

Contributor Information and Disclosures

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