This video is used to demonstrate portions of a rhinoplasty called an osteotomy. When a large hump needs to be removed during rhinoplasty, there are two ways in which the hump can be removed. In the first way, a sharp knife, called an osteotome, is used to remove the bone portion of the hump down to a lower position. Once the hump is release, the surgeon uses a forceps to remove the hump. The second way is performed by "filing" down the bone using an instrument called a rasp. Sometimes both of these techniques are combined. Occasionally, after removing the hump, a gap may exist between the two nasal bones. When this occurs, the bridge of the nose may appear to be wide. This is called an "open roof." On order to correct this, the surgeon will "close" the open roof by cutting the bone on wither side of the nose. This is called a lateral osteotomy and is used to narrow the bones. Once this is completed, the nasal bones are narrowed and the rhinoplasty is complete. Osteotomies can be performed in a very elegant fashion, minimizing any surrounding trauma. This is often dependent on the surgeon's technique.