Cosmetic rhinoplasty with narrowing of the bony vault can potentially reduce the nasal airway. Current surgical methods may aggravate this problem. In an attempt to demonstrate the effect of lateral osteotomy on the resultant airway, 4 cadaver specimens were studied grossly and with CAT scans. It appeared that variations in osteotomy technique did have a demonstrable impact on the size of the nasal airway. An interrupted transperiosteal approach, preserving intervening strands of periosteum, resulted in a more stable nose with less compromise of the airway.