Open Vs Closed Rhinoplasty

The question of whether Open or Closed rhinoplasty is the best surgical method – is one of the most debated topic in rhinoplasty surgery. There is no simple answer to this question as the “best method” is dependant on the rhinoplasty procedure you’re intending to undergo.

Rhinoplasty is accomplished by removing excess bone and cartilage from beneath the skin covering the nose. In some cases, cartilage grafts are added to help reshape and strengthen the nasal framework.

After alteration of the supporting structures of the nose, the skin is repositioned over the newly shaped framework to give the nose its new appearance. The changes may be subtle or dramatic, depending on the needs of the patient.

Closed Rhinoplasty

Closed Rhinoplasty refers to a nose job that is performed via internal incisions – i.e., there are no external scars. The surgeon makes one or more incisions along the inside of the nose and lifts the skin up from the nasal framework. Once the skin is elevated, he may correct the nasal septum, graft cartilage, remove excess tissue allowing your nose to be altered.

Advantages:

  • Potentially shorter operative time
  • Less swelling of the tip
  • No external scar

Open Rhinoplasty

Closed rhinoplasty is appropriate if:

1. The end of the nose has exceptional form (not too broad, not crooked).
2. The tip is not over projected (standing out far from the face) or under projected (rests near the face).
3. The nose is not as well long, with a sagging tip.
4. If there is a bulge to be fixed, it’s simply a tiny bulge.
5. The nose is not specifically asymmetric.
6. There is no other nasal attribute that would need a complex surgery for its adjustment.

Open Vs Closed Rhinoplasty Before and after

Open Vs Closed Rhinoplasty Before and after

Open Rhinoplasty

Open Rhinoplasty uses the same incisions as a closed rhinoplasty with the addition of an incision on the undersurface of the column of tissue that separates the nostrils called the columella. While this places a small scar on the exterior of the nose, in most cases, the incision heals very well and is not noticable at conversational distances. The scar will eventually fade overtime and foundation may cover slight blemishes.

Many rhinoplasty surgeons opt for open rhinoplasty for revised nose job because it allows for precision and allows a surgeon to re-engineer a mishappen nose.

Advantages:

  • Better visualization for the surgeon
  • Direct exposure of the anatomic structures
  • More precise intraoperative diagnosis
  • Less distortion of the nasal framework from intraoperative retraction
  • Ideal for complex nasal deformities

closed rhinoplasty

Closed rhinoplasty is appropriate if:

1. Significant enhancement with tip, spreader, columellar and/or shield grafts.
2. Improvement of intricate nasal defects such as cleft lip, palate nasal defect and deviated
septum or nasal injury.
3. Alteration rhinoplasty.
4. Excision of nasal lump.
5. Procedure of inner nasal valve disorder.
6. Nasal tip alteration.
7. Surgical repair of septal openings.
8. Nose surgery in nonCaucasian
ethnic teams.

Which approach is “best” for you?

While you may have a preference for one or the other, your surgeon will recommend the approach that he or she feels is most appropriate. It will also depend on the goals established by you and your surgeon. Some surgeons perform exclusively closed rhinoplasty while others prefer open rhinoplasty. There are surgeons who perform both types of rhinoplasty depending on the patient’s needs.

 

 

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