What is Rhinoplasty without Osteotomy?

Rhinoplasty without osteotomy, also called no osteotomy rhinoplasty, is a less invasive approach to nasal surgery.

Unlike traditional rhinoplasty, which may involve breaking and resetting the nasal bones (osteotomy), this procedure focuses on making subtle changes to the cartilage and soft tissues of the nose.

In general, nasal bone osteotomies are used to close an open roof deformity after hump removal, narrow the lateral walls of the nose, and proportionately align the nasal bone framework to correct any asymmetry. However, the no-osteotomy procedure can also address various concerns, including reshaping the nasal tip, adjusting the nasal septum, and sometimes it is used for dorsal hump reduction.

Evidence-based medicine ratings back this innovative technique, which has been the subject of numerous studies published in reputable medical journals. These studies have shown that rhinoplasty without osteotomy can effectively address a variety of nasal concerns while minimizing potential risks and complications.

Rhinoplasty Before & After

The before and after gallery represents a small fraction of the patients Dr. Shah has operated on. He has many more examples of his work in his office. The gallery is intended to show a variety of aesthetics. All pictures shown are from patients of Dr. Anil Shah.

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The Benefits of Rhinoplasty without Osteotomy

There are several benefits to choosing rhinoplasty without osteotomy over traditional rhinoplasty techniques. These include:

  • Less nose trauma: Since the nasal bones are not broken during this procedure, there is less risk for people with fragile nasal bones and less risk of damage to the surrounding tissues and blood vessels, leading to reduced swelling and bruising post-surgery.
  • Faster recovery time: Recovery after rhinoplasty without osteotomy is typically quicker, with less downtime and a faster return to normal activities.
  • Reduced risk of complications: By avoiding osteotomies, the potential risks associated with traditional rhinoplasty are minimized.
  • More precise results: This procedure allows for greater control and precision in reshaping the nose and the ability to avoid uncontrolled fracture lines.

Often, the desired changes to the nose can be achieved by carefully manipulating the nasal bones and cartilage without resorting to osteotomies in rhinoplasty, including medial osteotomies, lateral osteotomies, or bilateral osteotomies.

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Who is a Good Candidate for Rhinoplasty without Osteotomy?

This procedure may be suitable for patients who require revision rhinoplasty to correct minor imperfections that resulted from the primary rhinoplasty. For patients that wish to only have dorsal hump surgery, a qualified facial plastic surgeon will do a physical examination to determine whether you have a bony hump or cartilaginous hump, or both. The osteotomy brings the bones together, which is necessary sometimes. Ideal candidates for rhinoplasty without osteotomy are those who require minor adjustments to the nasal structure, such as refining the nasal tip, correcting a small nasal dorsum hump, or addressing minor asymmetry. Also, wide nasal bones can be more precisely narrowed without osteotomy. This is especially beneficial for ethnic rhinoplasty which can look over-narrowed, as the no-osteotomy technique allows for more subtle nasal bone alterations. At your consultation with Dr. Shah, board-certified in facial plastic surgery, he will determine whether rhinoplasty without osteotomy is the right approach for your specific needs and goals.

The Procedure for Rhinoplasty without Osteotomy

Rhinoplasty without osteotomy is typically performed under general anesthesia or sedation. Small incisions will be made by the surgeon inside the nostrils for closed rhinoplasty or along the columella, the tissue strip separating the nostrils, for open rhinoplasty. The nasal cartilage and soft tissues can be accessed through these incisions to make the desired changes.

The surgeon may reshape the nasal tip, reduce a nasal hump, or adjust the angle between the nose and upper lip, depending on the patient’s needs. After making the desired changes, the incisions are sutured closed, and a splint may be applied to maintain the nose’s new shape during healing.

Additionally, the surgeon might address underlying functional issues like a deviated nasal septum or nasal valve collapse to improve breathing and overall nasal function.

In some cases, the rhinoplasty surgeon may use an internal approach or endoscopic comparison to visualize the nasal structures and ensure precise adjustments. This can help minimize postoperative edema, periorbital edema, and other potential complications associated with traditional rhinoplasty surgery. It is essential to choose a skilled and experienced facial plastic surgeon or plastic surgeon who specializes in rhinoplasty without osteotomy. This will ensure the best possible outcome and minimize the risk of complications or the need for revision surgery.

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Recovery Time for Rhinoplasty without Osteotomy

The recovery after rhinoplasty without osteotomy is generally shorter than that of traditional rhinoplasty procedures involving osteotomies. Patients can expect to experience some swelling, bruising, and discomfort in the days following surgery, but these symptoms typically subside within one to two weeks.

To ensure a smooth recovery, it is crucial to adhere to your surgeon’s post-operative care instructions.

These may include:

  • Avoiding strenuous activity for at least two weeks to minimize swelling and promote healing
  • Keeping the head elevated, especially when sleeping, to reduce swelling
  • Using cold compresses to alleviate bruising and swelling
  • Taking prescribed pain medication as needed to manage discomfort
  • Avoiding blowing your nose or engaging in activities that could cause nasal trauma during the healing process
  • Attending follow-up appointments with your surgeon to monitor your progress and address any concerns

The initial recovery period for rhinoplasty without osteotomy is usually shorter than traditional rhinoplasty; however, it may take several months for the final results to become apparent as the nose heals and settles into its new shape. Patience and adherence to your surgeon’s recommendations will help ensure the best possible outcome.

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Possible Complications of Rhinoplasty without Osteotomy

As with any surgical procedure, rhinoplasty without osteotomy carries some potential risks and complications. Although these complications are generally rare and less likely to occur than with traditional rhinoplasty involving osteotomies, it is essential to be aware of them and discuss them with your surgeon during the consultation process. Some possible complications of rhinoplasty without osteotomy include:


Although rare, an infection can occur after any surgery. Following your surgeon’s post-operative care instructions can help minimize this risk.


Some postoperative bleeding is expected after rhinoplasty, but excessive bleeding can lead to complications. Your surgeon may recommend avoiding certain medications and supplements that could increase bleeding risk.


While rhinoplasty without osteotomy typically results in less visible scarring than traditional rhinoplasty, some scarring may still occur. Your surgeon will discuss the specific techniques they use to minimize scarring.


In some cases, the nose may not heal symmetrically, leading to an uneven appearance. Additional surgical procedures may be required to correct asymmetry.

Breathing difficulties

Although rare, some patients may experience difficulty breathing after rhinoplasty without osteotomy. This can typically be addressed with additional surgical intervention if necessary.

It is crucial to choose an experienced rhinoplasty surgeon who is skilled in performing rhinoplasty without osteotomy to minimize the risk of complications. During your consultation, make sure to discuss your concerns and ask any questions you may have about the procedure and its potential risks.

Some quick background: Prior to my revision rhino/septoplasty with Dr. Anil Shah approximately 1 year ago, I had been modeling on a very infrequent level and got booked for only about a photoshoot a month, largely due to the huge amount of time I had to dedicate to contouring my nose before photoshoots and because I couldn't ever take shoots where I'd have to come in with a fresh face (no makeup). Today, I’ve been chosen to represent major brands (including from Microsoft and Mercedes-Benz) and average about 3-4 shoots/week, if not more.

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Rhinoplasty without Osteotome FAQ

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Can rhinoplasty without osteotomy address all nasal concerns?

Rhinoplasty without osteotomy is best suited for patients with specific concerns, such as a dorsal hump or minor asymmetries. It may not be suitable for those with more complex issues, such as an open roof deformity after hump reduction. An experienced rhinoplasty surgeon will evaluate your individual needs and determine if this procedure is the right option for you.

How long does the rhinoplasty without osteotomy procedure take?

Depending on the case’s complexity and the specific techniques utilized, the procedure time for rhinoplasty without osteotomy can vary. On average, the surgery takes about 1-2 hours to complete.

Is rhinoplasty without osteotomy less expensive than traditional rhinoplasty?

Rhinoplasty without osteotomy can sometimes be less expensive than traditional rhinoplasty, as it is typically a less invasive procedure with fewer risks and a shorter recovery time. The cost of any surgery is dependent on the specific techniques employed, the required anesthesia, and the surgery’s difficulty. It is essential to discuss the cost of the procedure with your surgeon during your consultation.

Will insurance cover rhinoplasty without osteotomy?

Insurance coverage for rhinoplasty without osteotomy will depend on your specific policy and whether the procedure is deemed medically necessary. Insurance is unlikely to cover the surgery if it is performed for cosmetic reasons. However, if the procedure is being performed to address functional issues, such as breathing difficulties, your insurance may provide coverage.

Can I combine rhinoplasty without osteotomy with other facial procedures?

It is possible to combine rhinoplasty without osteotomy with other facial procedures, such as a facelift or eyelid surgery, depending on your individual needs and goals. Combining procedures can help achieve a more harmonious and balanced facial appearance. However, it is essential to discuss this with your surgeon during your consultation to determine the best approach for your specific situation.

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