What is an open Rhinoplasty?
I’ve read some articles mentioning open rhinoplasty and am curious about what it means. Aren’t all nose surgeries open? Is there a way for the doctor to manipulate the nasal shape without cutting the skin open?
Good question! The difference between open and closed rhinoplasty is confusing to patients because the terms are not straightforward. What we really mean is "open tip" vs. "closed tip," which means do we make an incision on the external visible skin at the bottom of the nose or not. Closed and open tip rhinoplasty both involve incisions on the inside lining of the nose (where you might pick your nose inside the nostrils), which allows a surgeon to do many maneuvers to reshape the nose and septum. Some surgeons use this approach in all rhinoplasties, but most surgeons (including myself) believe we get better exposure and control over the tip cartilage and the overall shape by adding an incision across the columella (the skin and cartilage bridge between the nostrils), which allows us to "look under the hood" by pulling the skin of the nose up to reveal the cartilage from the front, as opposed to delivering it through the inside incisions for manipulation. Hope this helps! -- Dr. Sayed Visit us at http://www.timsayedmd.com Email us at email@example.com Call us at 1-858-24SAYED (1-858-247-2933) Follow us on Twitter and Instagram: @timsayedmd
Thank you for your question. All rhinoplasties are not open. Some can be done closed. Open means that a small incision is made on the thin part of the skin by the upper lip. This incision is continued inside the nose and the nasal skin is lifted up like the hood of a car to expose the structure of the nose to be manipulated. Sometimes, these manipulations can be done only through small incisions on the inside of the nose. This really depends on the surgeons preference and the extent of manipulation that needs to be done. The recovery is very similar if the same manipulation is done. The only thing that is avoided is the small scar on the bottom portion of the nose which usually heals very well if done correctly. I hope this helps.
Open Rhinoplasty is the addition of a small incision in the columella of the nose allowing for the tissues to be elevated and in particular, the nasal tip exposed. This allows for the most accurate correction of multiple nasal issues many of which are not treatable with a closed procedure. The majority of the best Rhinoplasty surgeons in the country will predominantly use this technique- In our practice this is (95% or more. There are no significant negatives and the incision is virtually invisible in the vast majority of patients. There is if anything less bruising and swelling as one is able to be very meticulous and gentle with the procedure.
Open rhinoplasty is an invasive procedure that consists of peeling back the layers of skin on the nose to reveal the underlying cartilage. A small incision that is placed between the nostrils allows access and additional incisions made be made inside the nose. Most educated, experienced surgeons can place these incisions in places that are so arbitrary that they will cause no cosmetic issues ( http://www.bostonrhinoplasty.org/open-rhinoplasty.htm ). The procedure made its way into US operating rooms in the 1990s and is a preferred method of rhinoplasty by most medical students today.
The "open" access of the nasal structures via this method allows surgeons to reshape, reduce, and support nasal cartilages in a more effective manner. However, does this make an open rhinoplasty preferable over a traditional rhinoplasty? In general, the answer is "no." No two nose jobs are alike, and it mainly depends on the surgeon and patient's preference in selecting a rhinoplasty technique. Certain patients may require this method to achieve the results they desire. Or some surgeons may simply prefer to use this technique when at all possible for a variety of reasons.
In general, an open rhinoplasty takes more time to perform that alternative options. The initial opening and final closing of the nose during this procedure can add an hour or more to the overall operating time. There may also be more scarring and swelling may last longer, due to the invasive nature of an open rhinoplasty as opposed to a closed rhinoplasty. This is a result of the tissues that must be separated to gain access to nasal cartilage.
There are two approaches used by surgeons who do rhinoplasty "open or closed techniques". With the open approach an incision is made across the columella skin and then into the nose allowing the surgeon to view the anatomy but it leaves a scar across the. Olumella. With the.closed approach all incisions are hidden inside the nose. The open approach makes the surgery easier on the surgeon. Personally I prefer the closed approach because I technically can do everything that others do open and do not like putting a scar across the.columella
Dr. Frederic Corbin has 1 Nose job before & after:
Hello, and thank you for your question! Different surgeons will have different opinions depending on their experience and training. My opinion is that there is rarely if ever a need to "open" the nose. A closed approach allows the experienced surgeon complete access to all structures and excellent visualization. The advantages include a much more vascularized nose ( two big arteries reside in the columella), better tissue envelope to support grafting (which you will need), avoidance of external scarring/notching and very importantly it leaves the lip-columella-tip relationship intact during surgery, allowing the surgeon to more accurately evaluate the aesthetics of the intervention. It is true that open rhinoplasty is much much easier and requires less technical expertise. The open approach is much better for training and demonstration purposes. Personally having trained with world class craniofacial and aesthetic surgeons such as Fernando Ortiz-Monasterio and Molina I adopted their bias that opening the nose is not necessary( outside of reconstructive cleft work etc. ) and is negatively affects healing, graft take and ability to accurately judge the intraoperative result. Having extensive experience with Mestiso and ethnic rhinoplasty I would suggest you find someone with similar craniofacial experience as your rhinoplasty will require advanced grafting technique. Recently, liquid rhinoplasty’s have been in high demand and it has been a popular topic. I asses each patient individually and what changes in their features would improve their aesthetics most. We find that most patients looking for a surgical rhinoplasty end up being a great candidate for a non-surgical rhinoplasty. The Aesthetic Facial Balancing technique allows patients to get similar results as a surgical rhinoplasty as well, but with very little recovery time (avoiding residual swelling that can last up to one year) and giving them instant results in less than 20 minutes, with results lasting for up to 6 years. I hope this helps! All the best, Dr. Rian A. Maercks, M.D.
Dr. David M. Tauber, MD - DeLucaPlasticSurgery.com - Albany, NY
A open surgical rhinoplasty removes and repositions tissue in the nose for better aesthetics. This often involves removing dorsal humps, lifting drooping tips, and narrowing the nose - making the nose appear smaller overall. The only small skin incision is in the columella (the skin between the nostrils) and this small incision heals very well.
In contrast, a non-surgical rhinoplasty uses fillers off-label to camouflage small deformities by adding volume to the nose. Thus, you trade a small bump for a bigger nose. This procedure is best suited for people with small noses and small deformities that are looking for a temporary fix for a subtle problem.
See the following link for more info on rhinoplasty http://tiny.cc/rhinoplasty
A detailed examination will help delineate the best option. Consultation with a plastic surgeon would be the next best step.
A detailed examination will help delineate the best surgical option and provide you a custom quote for your situation. Call 518-724-2444 today to schedule a free phone or in person consultation!
Dr. David M. Tauber, MD - Board Certified Plastic Surgeon - DeLucaPlasticSurgery.com
Thank you for your question. Open rhinoplasty is when the surgeon makes an incision across the columella of the nose (the skin between the nostrils). The surgeon then extends the incision along the inside of each nostril. This allows the surgeon to separate the skin and soft tissues of the nose from the cartilage and bone. This allows excellent visualation of the nasal skeleton which may allow a more precise sculpting of the nose. The soft tissues are then replaced and sutured. I hope this helps.
Dr. David Steckler has 1 Nose job before & after:
Thanks for your question! An "open" rhinoplasty means an incision is made across the columella (which is the skin that separates the nostrils). A "closed" rhinoplasty does not require any external incisions. Surgeons will argue which way is better but one is not clearly superior to the other. If you trust your surgeon, trust him or her to use the technique to give you the best result.
Dr. Jeffrey Horowitz has 1 Nose job before & after:
Yes if there are limited changes that you would like to your nose a "closed" rhinoplasty can be performed. There is a small incision on the inside of your nose as opposed to an open approach which has a small external incision on the undersurface of your nose. Some surgeons prefer an open approach to a closed approach for better visualization of the underlying framework of the nose.
Hi there. An open rhinoplasty is performed by making a horizontal incision at the bottom of the nose between the nostrils. A closed rhinoplasty involves surgery through the nostril hence no visible external incision.
Hope this helps.
Dr. Carlos Burnett has 2 African American Rhinoplasty before & afters:
Open involves a cut across the columella (the support between the nasal openings) the skin is then lifted up and the structures of the nose directly observed and modified.
Closed rhinoplasty has no incisions externally and the surgery is within the nose (sort of inside out, upside down)
An open rhinoplasty is when a small incision is made on the skin of the collumellar. that is the part which divides the nostrils down the middle. Not all rhinoplasties are open. A closed rhinoplasty is when all the incisions are kept inside the nose. If one has a nose which requires a significant amount of work on the tip or if the nose has been operated on before, open may be preferable. A good nose surgeon should be able to do both. Having been trained in both ENT and Plastic and reconstructive surgery I reserve the open technique for the more challenging cases.
An open rhinoplasty is with complete exposure of the nose. The skin is actually lifted up all the way from above the lip back to the root of the nose and allows full exposure of all of the structures. This allows for much more refinement and delicate tip work. Obviously this is going to be a longer recovery In terms of swelling. In a closed rhinoplasty, anincision or incisions are still necessary to get access but the tissue is not lifted up off of the nose. Not all rhinoplasty techniques are possible through this approach
Dr. Christopher Park has 1 Nose job before & after:
Open rhinoplasty is a more invasive approach in which a cut is made on the columella, which is the column of skin in between the nostrils. Most rhinoplasties however can be made in a closed approach which involves incisions lateral and hidden from the columella. In some cases some minor external cuts can be made on the alas (wings of the nose) particularly for some ethnic patients. Best wishes.