Why do I continue to perform vestibular osteotomies?

The rhinoplasty surgeon can choose from different osteotomy techniques. Historically, when changing the bony contour of the nasal pyramid, more attention has been devoted to refining approach to osteotomy techniques and adapting the instruments used. The importance of less damage to the soft tissues led rhinology surgeons to develop more refined osteotomy instruments. The author gives an overview of historical developments leading to our current array of techniques for addressing specific demands about aesthetic and functional outcome. A brief outline is given of the advantages, drawbacks and pitfalls of different osteotomy techniques.