Open Vs Closed Rhinoplasty
There are two basic approaches to rhinoplasty: the open technique and the closed technique. Both have their advantages and disadvantages and the best technique will depend on your individual case.
Open rhinoplasty is a technique that utilizes a small incision across the base of the columella. The columella is the soft tissue that separates the two nostrils. By making this incision, the doctor can lift up the skin and directly access the underlying nasal structure.
This gives the doctor direct visualization of the cartilages, so it easier to accurately alter the nasal shape.
While this is often preferable for the doctors, it is not always preferable for patients. The fact that the incision is made across the columella means that there will be a small resulting scar. Despite the fact that this tiny scar will continue to fade over time and is discreetly hidden, the idea of acquiring a facial scar is not often desirable.
However, open rhinoplasty is often necessary for correcting more severe nasal concerns. Some of the concerns most frequently addressed with open rhinoplasty include bulbous or boxy nasal tips or a lack of nasal tip projection. If you require internal sutures, then they will require open rhinoplasty. This is also the best method if it is a secondary rhinoplasty procedure, meaning you have undergone rhinoplasty before.
Closed rhinoplasty is a technique that only uses incisions inside of the nostrils. By making these incisions, there will be no visible scarring following the procedure. However, it also gives the doctor less direct access to the nasal structure.
It is important when having a closed rhinoplasty to make sure that the surgeon performing the procedure is trained and experienced in this technique.
Another benefit of closed rhinoplasty is that it decreases the operating time. This means that there is less swelling and that recovery time is also significantly reduced.
Bump or hump removal can often be corrected using the closed rhinoplasty technique alone. It can also frequently be used if this is a primary rhinoplasty, meaning that it is your first nose surgery.
Doctors without knowledge of proper closed rhinoplasty techniques may not be able to attain your desired results or, worse, may cause trauma to the nose in some way.
Meeting with a board certified plastic surgeon who specializes in rhinoplasty is the best way to determine whether or not you would benefit most from open or closed nose surgery. During the consultation, Dr. Hamawy will take x-rays and photographs of the nose. He will also take measurements and discuss with you what you’d like to achieve from rhinoplasty. All of these findings will go into determining whether or not an open or closed technique would be best for you.
It is important to keep in mind that even when using an open technique, the resulting scar will not be obvious or clearly visible. When performing open nose surgery, Dr. Hamawy positions the incision in a discreet, hardly-noticeable location. The scar will continue to fade over time and, in some cases, disappear completely. During the consultation, we can provide you with photographs of other open rhinoplasty patients to give you a realistic understanding of what the scar will look like.