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Updated: Apr 18, 2026
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Superior rhinoplasty outcomes with precise nasal osteotomy: an individualized approach for maintaining function and
Mohammad Ghanaatpisheh1, Ali Sajjadian1, Rollin K Daniel1
1Dr Ghanaatpisheh is a plastic surgeon in private practice in Tehran, Iran. Drs Sajjadian and Daniel are plastic surgeons in private practice in Newport Beach, CA.
Background:
Although frequently performed in rhinoplasty, nasal osteotomies have been unpredictable in consistently controlling postoperative alterations in bony morphology in many patients. Consequently, a detailed algorithm for an individualized approach to osteotomy is needed to achieve superior aesthetic and functional outcomes.
Objectives:
The authors aimed to propose a component-oriented and individualized approach for nasal osteotomy in rhinoplasty.
Methods:
Clinical outcomes were reviewed for 150 consecutive patients who underwent rhinoplasty. Type and frequency of specific osteotomy procedures and preoperative and postoperative photographs were examined.
Results:
A total of 97 cases with at least 12 months of follow-up data were evaluated. In 92 of 97 patients (95%), a lateralized medial oblique osteotomy was performed; 70 (72%) required bilateral intermediate osteotomy, and 21 (22%) required unilateral osteotomy. Forty-one patients (42%) underwent bilateral base osteotomy and 24 (25%) underwent unilateral base osteotomy. No base osteotomy was performed in 32 patients (33%) who had aesthetically pleasing lateral wall width and no convexity of the posterior portion of the lateral bony wall.
Conclusions:
The osteocartilaginous vault is asymmetric in the majority of patients undergoing rhinoplasty. Anatomic variations in the height, length, and/or width of the bony vault can significantly influence its shape and symmetry. Various principles and techniques for nasal osteotomy increase predictability of outcomes while improving nasal aesthetics and function. LEVEL OF EVIDENCE 4: Therapeutic.
