Nasal Bone Osteotomy with Narrowing, Tip Plasty, Alar Rim Lowering (Skin Graft, Auricular Cartilage Graft)

Treatment details: Nasal Bone Osteotomy with Narrowing, Tip Plasty, Alar Rim Lowering (Skin Graft, Auricular Cartilage Graft)

The lateral view is the honest one for this operation. A narrowing osteotomy can look convincing from the front while the dorsal profile still shows a residual hump or an over resected saddle, so I judge the bony work by the straightness of the line from radix to supratip. Here the tip framework was rebuilt with the patient’s own auricular cartilage, which holds projection without the rigidity of a synthetic implant. Lowering the alar rim required both a graft bed and cartilage support, otherwise the margin retracts again as the scar matures. At six months the profile has settled, though the supratip stays firm for a while longer.

Osteotomy of the nasal bones brings swelling across the midface and bruising around both eyes that is heaviest in the first week and largely gone by the third. A splint is worn initially and the nose feels blocked while the lining recovers. The bone can unite with a small step or a slight deviation, and a proportion of patients choose correction once healing is complete. Tip cartilage work keeps that area firm and numb for six months or longer, and suture edges may become palpable as the skin thins. A rim graft depends on new blood supply, so partial loss, a color mismatch or a texture difference at the nostril margin is possible. The ear donor site leaves a scar. Bleeding and infection are uncommon.