What's the difference between
"open" rhinoplasty and "closed" rhinoplasty?
an "open" rhinoplasty, a small incision is made in the
columella, which is the little column of skin that separates the two
nostrils. That incision allows the nasal skin to be lifted off of the tip of the nose.
That's the only difference between the two techniques. In both open and closed rhinoplasty,
many other incisions are used up inside of the nose, but the open technique
also has that one little extra incision in the base of the nose.
photos below show the location of the open incision. The two
identical photos were taken
after healing is complete. It's quite hard to find the scar.
open technique has huge advantages over the closed technique, in my opinion. The main advantage is that it is much easier
for the surgeon to see and work on the nasal tip cartilages in their
natural positions. With the skin lifted up, it's easier for the
surgeon to see what needs to be done, and to accomplish those tasks.
The little scar heals superbly.
use of the open technique allowed me to take all of the nice
intra-operative photographs that you see in the intra-operative
rhinoplasty tutorials on this Web site. Open rhinoplasty is a great
surgeons debate the advantages and disadvantages of the open vs. closed
techniques, just like they debate practically everything, and you'll find
plastic surgeons who argue vehemently for each technique. I strongly
favor the open approach, but some plastic surgeons get
excellent results with closed rhinoplasty, so don't select your surgeon
based on the open vs. closed question. Select your surgeon based on
his overall skill in performing rhinoplasty. Go here
information on finding a competent rhinoplasty surgeon.
will occasionally use the closed approach for a nose, if all of the
following conditions are present before surgery:
of the nose has excellent shape (not too wide, not asymmetric)
tip is not overprojected (sticking out too far away from the face) or
underprojected (sits too close to the face)
nose is not too long, with a drooping tip
there is a hump to be corrected, it's only a small hump
nose is not particularly crooked
is no other nasal feature that would require an unusual or complicated
surgical technique for its correction
All of those conditions don't happen too frequently;
I use the closed technique only about
5% of the time.
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