Nasal osteotomy--utilizing dual plane reciprocating nasal saw blades: a 6-year follow-up.

Observation of the nasal bone anatomy has demonstrated a double S-curve configuration from the base of the pyriform aperture to the medial canthus. The most common method of osteotomy uses a curved osteotome or a chisel. The movement of either is facilitated by tapping with a mallet. With this method, frequent green-stick fractures, fragmentation, and other complications have been encountered. For the last 6 years, a dual plane, curved stainless steel blade has been used to accomplish low to high osteotomies. This gives a precise lateral transverse osteotomy without medial osteotomy being required. This technique allows the operator to produce a well-defined and precise lateral osteotomy with fewer potential complications and less postoperative swelling as well as improved patient comfort. In cases of secondary rhinoplasty or old nasal trauma, sites of previous fibrous union are able to be osteotomized with precisely controlled cuts, avoiding unpredictable fragmentation or fracture lines.