The pictures above show the location of the external incision for a
rhinoplasty, a dotted line shaped like an inverted "V." Other incisions are hidden up inside the nose,
but when an "external" incision, meaning an incision on the outside
skin, is used, the operation is called an
"open" rhinoplasty. A "closed" rhinoplasty is when no
incision on the outside skin is made.
This open
rhinoplasty incision
is placed across the part of the nose called the "columella."
The columella is the central column of tissue that separates the nostrils,
colored blue in the diagram above right.
Note that the incision across the columella, or the "trans-columellar"
incision as we call it, cuts across the narrowest part of the columella (red
arrows). The columella is wider above and below the position of those red
arrows.
The skin of the columella is very thin, and the incision is short, so the
resulting scar is all but invisible after healing. Making the incision in the shape of
an inverted "V," rather than a straight line from the left to the
right edge of the columella, also helps make an
invisible scar.
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