Braithwaite Nasal Chisel | Left and Right Tips

What the Braithwaite nasal chisel is

The Braithwaite nasal chisel shaves and contours the bony nasal ridge in rhinoplasty and nasal reconstruction. The shaft is slender, so it runs along the ridge without the handle fouling the cheek or brow, and a guard is built into one side of the blade.

The guard is why this instrument exists as a separate pattern, and why it is handed. One side of the blade is a raised shoulder rather than an edge. Laid against the soft tissue that is staying, that shoulder stops the edge reaching it, so the cut can be taken right up to the boundary. An unguarded chisel has to be held off that boundary by hand.

Because the guard is on one side, a left guarded blade and a right guarded blade are different instruments, and a surgeon working both sides of a nose needs both. Adas Instruments makes it left guarded, right guarded, or as a matched pair.

Key design features of the guarded nasal chisel

The guard, and what it actually does

A raised shoulder along one side of the blade, standing slightly proud of the edge. It does two things. It shields whatever is on that side, normally the mucosa or periosteum being preserved. And because the shoulder touches bone before the edge reaches full depth, it limits how deep one pass can go, so the reduction happens in known increments.

Left guarded, right guarded, or a pair

The handedness is geometry, not preference. On the left wall of a nose the guard has to be on the left of the blade to sit between the edge and the tissue; on the right wall it has to be on the right. One blade does one side properly and the other awkwardly, which is why the pair is the usual order for a rhinoplasty tray.

A slender shaft

The shaft is narrow through its length so the blade can be advanced along the nasal ridge through a limited opening. The trade off is honest: a slender shaft places more easily and transmits a mallet tap less rigidly than a heavy one, which is why this is a contouring chisel rather than one for dividing thick bone.

A flat handle end, and one piece throughout

The far end of the handle is a true flat face, so a mallet lands square and the whole tap goes forward into the blade. There is no joint, screw or moving part on the instrument, so nothing works loose and there is nowhere for tissue or cleaning solution to sit.

Which Braithwaite nasal chisel to order, left, right or the pair

One blade pattern in three configurations, and the configuration is which side the guard is on. Every row below is our own product record.

For a tray that will see both sides of a nose, order the pair. For one instrument, the choice follows the side the surgeon works from most often.

Where the Braithwaite nasal chisel is used

Every row is nasal. The word chisel arrives here carrying two other meanings, the workshop one and the dental one, so the table says what this instrument is bought for.

In all of these the soft tissue is lifted first, the guarded face is laid against whatever is being preserved, and the chisel is advanced by short mallet taps.

What it cuts, and what it has to leave alone

This is the one page in the family where the tissue table is the point of the instrument rather than a caution attached to it. The guard exists to make one row of it impossible.

The fourth row is the whole argument for a guarded chisel. On an unguarded blade it reads “protected by hand and by judgement”. Here it reads “protected by the instrument”.

How it compares with the rest of the nasal chisel family

Five nasal chisels sit beside each other here, told apart by the SHAPE OF THE EDGE and by whether the blade carries a guard. This one and the Silver are the two guarded patterns, and they guard different things.

Between the two guarded chisels: this one is a flat blade guarded on one side, made left and right, for bone along the nasal ridge. The Silver is guarded on a single side too but is made at 3mm, 5mm and 7mm for the cartilage framework. If no guard is needed, the Sheehan is the flat blade and the Walter and McIndoes are the curved ones.

Braithwaite nasal chisel materials and finish

The chisel is ground from high quality medical grade stainless steel, hardened through the blade so the edge holds its angle through resharpening, and left softer along the slender shaft so an off square tap sets no permanent bend. The steel itself is made to a German specification.

The finish is satin rather than mirror bright. A polished blade under a headlamp reflects light back up the nostril and satin scatters it. On a guarded blade satin has a second use: it makes the step between the guard and the edge easy to see, which is how you check the guard has not been dressed flat by over enthusiastic sharpening.

Caring for a Braithwaite nasal chisel

Rinse the blade under cool running water as soon as the case is finished, and pay attention to the angle where the guard meets the blade. That corner traps bone dust and it is the hardest place to clean once it has dried.

Ultrasonic clean in a neutral pH enzymatic solution, rinse in deionized water, then dry fully before pouching. Tap water dried on steel is the ordinary cause of pitting.

Autoclave at 134 degrees Celsius. Store with the edge guarded. One thing specific to this pattern: when it goes for sharpening, say that the guard must keep its height. A guard ground down level with the edge is no longer a guard, and the instrument looks perfectly serviceable until the moment it matters.

Ordering a Braithwaite nasal chisel, and wholesale

The Braithwaite nasal chisel is supplied as a single instrument, item code AM-32.02, left guarded or right guarded, or as a matched pair. It is ground and finished in our own workshop, so a set can be made with the handle pattern and finish matching the rest of the nasal chisels on a tray.

Wholesale and distributor pricing is available on quantity, and larger orders can carry a laser marked hospital or practice reference at no separate tooling charge. Send the quantity and the marking text and we will quote both.

Item code AM-32.02. Every instrument carries a three year replacement warranty against manufacturing defects. Stock items ship from our own workshop. Backorder items take 10 to 12 working days to make. Production is controlled under an ISO 13485 quality management system.

Frequently asked questions

What is a Braithwaite nasal chisel used for

It shaves and contours the bony nasal ridge in rhinoplasty and nasal reconstruction, and the guard on one side lets the cut be taken right up against soft tissue that has to be kept.

What is the difference between a chisel and an osteotome

The bevel, and it changes what the instrument does to bone. A chisel is ground on one face, so it has a flat side and an angled side: the flat side rides along the bone that is staying and the angle shaves material off the surface. An osteotome is ground symmetrically on both faces, so the edge sits in the middle of the blade and splits straight into the bone. A chisel takes a surface down; an osteotome divides a bone in two.

How does the Braithwaite nasal chisel differ from an osteotome and a periosteal elevator

Three instruments, three jobs. This chisel cuts bone on a single bevel, shaving a surface down. An osteotome cuts on a double bevel, splitting along a line. A periosteal elevator does not cut: it is blunt, and it lifts the periosteum and mucosa off the bone before either cutting instrument is used.

What is another name for a bone chisel

Osteotome is the usual synonym, and strictly it is a different instrument, as above. You will also see bone chisels listed as surgical chisels and under surgeon names such as this one. The bevel is the only sure way to tell which you are holding.

Should I order the left guarded or the right guarded Braithwaite

The guard has to sit between the edge and the tissue you are protecting, so the left guarded blade works the left side of a nose and the right guarded the right. Most trays carry the pair, and we supply it as a matched pair for that reason.

Related products and categories

• Silver cartilage chisel
• Sheehan nasal chisel
• Walter chisel

Browse the full range of osteotomes, chisels and gouges, or see the wider set of rhinoplasty instruments this instrument belongs to.