Let’s Talk Honestly About Nasal Osteotomy Rhinoplasty. #Dr. Lee Kyung-mook

This is Objet Plastic Surgery.

For this post, we prepared a story from Dr. Lee Kyung-mook, who always gives patients honest and sincere consultations. When patients meet with him, unlike at other hospitals, he clearly and straightforwardly tells them when something is “not needed” or “not effective.” Because of this, Dr. Lee’s patients have a very high level of trust in him.

He says he will also speak honestly about nasal osteotomy, so let’s hear what he has to say.

Nasal Osteotomy

Have you heard the term osteotomy often? You’ve probably heard of fractures, right? Fracture and osteotomy are synonymous. The difference between these words is as follows. A fracture refers to a bone breaking due to external impact or pressure, against one’s will, while osteotomy means intentionally breaking a bone with a certain purpose.

Then nasal osteotomy can be described as surgery that intentionally breaks the nose with a certain purpose. If a plastic surgery clinic says this needs to be done, it can be divided into two purposes: an aesthetic purpose to make the nose more attractive, or a treatment purpose to prevent runny nose. These are the two categories.

At Objet Plastic Surgery, we do not recommend nasal osteotomy very often. The only case in which nasal osteotomy is truly necessary is for patients with a wide nasal bridge, and it is effective only for those patients.

If someone cannot tell by looking with the naked eye, then there is no need to do it. But for people whose nasal bones are truly wide when viewed visually, osteotomy is absolutely necessary.

However, if another clinic recommends “nasal osteotomy” for someone whose nose only feels slightly wide when touched, Dr. Lee Kyung-mook stated a different view. Clinics do various forms of promotion and marketing to run their businesses, especially in areas like Gangnam, and he shared the opinion that nasal osteotomy seems to be one of the procedures that is often recommended in order to offset those costs.

Let’s look at the reason from here.

How Osteotomy Is Done

There are lateral osteotomy and medial osteotomy. In order for this procedure to be effective, both the medial and lateral sides, meaning both the inside and outside, must be cut.

However, most plastic surgery clinics only do the lateral side. If lateral osteotomy is performed, the nose may initially become narrower, but if you touch it about a year later, it is still wide.

At that time, patients often say, “I can’t really tell whether it got smaller because of the silicone implant or because the bone got smaller.” In other words, although it was cut, it returns to its original state.

Why It Returns to Its Original State If Only the Outer Side of the Nasal Bone Is Cut

Nasal bone osteotomy is not fixed with screws after narrowing it, unlike the cheekbones. Because of this, even if the bone is cut and becomes narrower at first, it tries to stick back to the original bone and keeps trying to come back out (to widen again). That is why, after nasal osteotomy, you need to wear a splint at home for almost a month in order to see the effect. But in reality, that is not easy to do. Wearing a splint can make daily life difficult.

Cases in Which Dr. Lee Kyung-mook Says Nasal Osteotomy Is Needed

If the upper part of the nasal bridge looks wide in the mirror, it should be done, but if the doctor touches it during consultation and says, “You definitely need osteotomy,” then you should consider it. Even after nasal osteotomy, it tends to return to its original shape, like a rebound effect.

In other words, if the nasal bones are judged to be truly wide at a glance, then it absolutely should be done. But if it is only considered “somewhat wide...”, then nasal osteotomy does not have much meaning, and if a silicone implant is inserted, the sides appear relatively narrower, so you can see the effect of the nasal bones becoming smaller.

Another thing to consider is the complication of rhinoplasty: “inflammation.” To prevent inflammation, the surgery must be performed with almost no bleeding. If blood remains around the silicone implant or around the cartilage after surgery, it can form a medium in which bacteria or germs can grow. Surgeries that place implants in the body, such as in the nose or breasts, should not involve bleeding. It is impossible for there to be absolutely no bleeding, but there must be as little bleeding as possible, and there should be no bleeding even after going home.

The hospital must make sure there is no bleeding before sending the patient home. To do that, surgeries that cause bleeding should not be performed, but osteotomy involves breaking bone. Also, most osteotomies are done blindly, so bleeding cannot be controlled. The doctor makes a hole on the inside or on the outside of the skin and breaks the bone by hammering on it to perform the osteotomy. Even if bleeding occurs, it cannot be controlled. Pressure is basically all that can be done. But in rhinoplasty, because it is opened and done directly, if bleeding occurs, it can be controlled. Because of this, nasal osteotomy has a very high chance of causing inflammation.

Unless the nose is truly wide, osteotomy is not recommended, but in the case of a crooked nose, osteotomy is necessary.

■ For Dr. Lee Kyung-mook’s real-life explanation of nasal osteotomy, please see the video for more details.

■ Nasal osteotomy, a time to meet Dr. Lee Kyung-mook~ ​