When we talk about the different techniques in nose surgery, this would usually refer to open and close rhinoplasty.
However, patients may not be sure which technique would be appropriate for them and how these would affect the final result. That is why in this article, I will go through on the advantages and disadvantages of each approach to understand which is appropriate for your case.
Now let’s go down to business.
Rhinoplasty is a procedure where excess bone and cartilage found under the skin that covers the nose are removed. In some cases a cartilage graft may also be added in order to improve the shape of the nose or strengthen its structure. Once the internal structures received their respective tweaks, the skin is then repositioned over it to finish the job. These changes created here can either be dramatic or subtle, depending on what the patient requests and on how the surgeon executes the procedure.
An open rhinoplasty is also referred to as external rhinoplasty. This nasal reshaping technique places the incision along the columella, or the strip of tissue found under the surface of the tissue that separates the nostrils. Afterwards the skin is lifted off the tip of the nose to reveal the structures inside.
One of the major benefits of an open rhinoplasty procedure is that it provides the surgeon better access to the underlying cartilage of the nose. It also allows him to manipulate the nasal shape with better precision and ease. In this manner there will be less distortion of the nasal framework due to intraoperative retraction.
Open nose surgery is preferred for purposes where major reshaping has to be done. This includes nasal projection has to be improved, to fix complex nasal deformities, and when the patient needs extensive nasal work done in multiple locations in one sitting.
In a revision rhinoplasty an open approach is often used especially since extensive correction may have to be done. In these instances a closed procedure may not also provide the access necessary for complicated revision rhinoplasties.
In most cases, the incisions created with open rhinoplasty, the incision can heal very well and may not even be noticeable even at close distance.
Closed rhinoplasty on the other hand is much preferred by patients because it is less invasive. The nasal reshaping is done through internal incisions which mean that it does not pose any risk in creating external scarring. There will also be no need for an incision along the collumela, therefore no sutures would have to removed later on as well.
Because it is less invasive, the procedure also has a shorter operative time. This is popular for most patients because they can have an easier recovery period. They experience less swelling at the nasal tip and most of all, it does not create aesthetic problems because there will be no visible scarring.
However, the problem with closed rhinoplasty is that it can be more difficult to perform. It would require expertise and great surgical skill to execute this procedure successfully because there is limited visibility. Here the entire operation is actually done through a narrow incision within the nostrils.
A closed rhinoplasty procedure is appropriate for minor tip and bone changes. A septal deviation can also be corrected through this approach if there are no simultaneous cosmetic alterations done to the nasal tip.
What we think
Whether if the approach used is an open or closed one, the goal is basically the same and that is to reshape the nose to create a better proportion in relation to other facial features. Both can improve the aesthetic appeal of the nose, which would also require altering the size, shape, projection or angulation. In addition to these, an improvement in the patient’s ability to breathe may also be the primary reason.
A patient should not choose a surgeon based on whether he prefers a close or open rhinoplasty. While you may have your own choice, it is important that the surgeon perform a certain technique based on what is appropriate for your own case. The decision will primarily depend on the goals that have been established by you and your surgeon.
Also you have to be very particular in choosing your surgeon. There are some who perform only close rhinoplasty or open rhinoplasty, while there are others that do both. This is necessary because not everyone has are skilled to pull off both. Skill and experience is an important factor.
Most patients may opt for a closed rhinolpasty because they want to avoid the visible scarring. But it is also important to be aware that a skilled surgeon and a good aftercare regimen can actually result to optimal healing with inconspicuous scarring even with an open approach.
Discuss what you want with your surgeon, and ask for before and after photos. See if his brand of work is what you are looking for, either for an open or closed approach.
If you are looking for ways to enhance your appearance, Advance Beauty Cosmetic Surgery in Brisbane, Melbourne and Sydney offers a range of aesthetic procedures, like rhinoplasty. A free consultation with Dr. Andrew Kim will allow you to discuss your expectations and methods available for you to achieve the look that you want.
In the end, it is your body and it is your choice if you want it to be improved or not. Just make sure that you will be safe and secured in your decision to do so.