Closed Rhinoplasty or Open Rhinoplasty — Which Technique Suits Your Needs
Open and closed rhinoplasty are two major cosmetic surgery techniques to perform nose reshaping surgery. At the time of pre-op consultation, the surgeon will carefully examine the patient’s nasal anatomy and evaluate their personal cosmetic needs to determine whether they will be more suited for open or closed rhinoplasty.
Open rhinoplasty is typically recommended when significant changes to the nose shape and size or functional corrections are required.
Closed rhinoplasty, on the other hand, will be preferred when only limited improvements to the nose are involved. Fantastic and astute facial plastic and reconstructive surgeon Dr. Eric Yavrouian provides rhinoplasty to patients in Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills CA, and surrounding communities in this part of the southwest.
In case of closed rhinoplasty, the surgeon will place multiple small incisions inside the nostrils. Parallel incisions may cover almost half of the nostril lining, but none of the incisions will be made externally. As a result, subsequent scarring will not be visible on the outside. This is a key aesthetic advantage for which many patients want to choose closed rhinoplasty cosmetic surgery.
However, in this procedure, the left and right nostril incisions remain disconnected from each other. Therefore, repositioning of the nasal skin may be more difficult, and the surgeon has to perform the entire surgery through narrow surgical openings with limited visibility.
Closed rhinoplasty may appear to be a less invasive technique, but it should only be performed by a highly skilled surgeon who has a detailed understanding of the nasal anatomy and can perform the procedure successfully despite limited surgical exposure.
Patients should also note that in case of closed rhinoplasty, some amount of nasal cartilage distortion will occur because access to the nasal framework requires significant stretching of the nasal skin. The procedure entails considerable surgical challenges due to these issues.
In case of open rhinoplasty, the surgeon will create a discreetly placed incision in the columella, which is a thin strip dividing the nostrils. This bridging incision will connect the left and right nostril incisions. The length of the visible incision will be about 4-5 mm.
Through this incision, the surgeon will fold the nasal skin upward and have unhindered visibility of the lower nasal skeleton. More significant corrections of the nose can be performed due to the direct visibility of the entire nasal framework. Furthermore, nasal cartilage distortion is minimized and individual components can be assessed in their natural, undisturbed alignment.
The surgeon will have substantially greater surgical access in case of open rhinoplasty because of the trans-columellar incision. Although a minor visible scar is unavoidable in open rhinoplasty, but the positive trade off is improved precision, versatility and effectiveness of this technique.
Weighing The Pros and Cons
Some patients (particularly those with straightforward nasal anatomy) can be treated through closed rhinoplasty, enjoying an improved appearance without scarring. However, the open approach is preferred. The advantages of a clearly visible operating area can lead to aesthetic results that outweigh the minor problem of a visible, but tiny, scar.
Using the open technique allows for the treatment of complex deformities and intricate issues, such as twisted noses, cleft lip, or post-rhinoplasty complications. These tend to be difficult to correct using a closed approach. In addition, the open approach is better suited for the correction of the nose tip since it causes so little damage to the internal structures of the area and achieves long-lasting results. For these reasons, the open approach is the preferred rhinoplasty approach in the majority of cases.
Choosing the Right Technique
With both techniques having high success rates, it can be difficult to choose which one is best for you. Usually, the verdict will be based on the natural shape of your nose, as well as your overall rhinoplasty goals.
For instance, if you want to make dramatic changes in your nose, an open rhinoplasty might be the way to go. This applies not only to people who have lofty aesthetic goals, but also those who suffered from traumatic injuries that necessitate a rhinoplasty. In this technique, your surgeon is given access to a larger part of your nose, making it easy for him to create drastic changes in your nose, including adjustments to your nasal tip. On the other hand, if you just want to address the bridge of your nose, then a closed rhinoplasty is already enough.