This is a basic surgical maneuver in most rhinoplasties of almost any kind, either primary or revisional, whenever the dorsum shows a prominent bump or, should it be smooth but raised, needs en bloc lowering or a reduction of the angle formed between the dorsum and the maxilla.
It is carried out with scalpel resection of the soft cartilaginous middle vault dorsum and precision chisel resection of the bony upper dorsum, with final rasping to smoothen any possible irregularities.
Open roof gap between the nasal bones and the osseous septum is an unavoidable consequence of dorsal resection, therefore it is mandatory to perform nasal bones infracture osteotomies to close it and prevent deformities requiring revision in the future.
This gesture can be done safely by either closed or open approach rhinoplasties.