Rhinoplasty, more commonly known as a “nose job”, is a procedure during which the appearance and/or function of your nose is/are modified by manipulating the nasal bones and cartilages. There are two main approaches that your plastic surgeon can use to gain access to your nasal structures: 1) the closed or 2) the open approach. The two techniques are more similar than they are different but patients frequently ask questions about when one technique is the most appropriate.
What is a Closed Rhinoplasty?
Also called the endonasal rhinoplasty, a closed rhinoplasty is a surgical approach where the incisions are located entirely on the inside of your nose. None of the incisions can be seen externally. All the corrections and changes of the septum, bone, and cartilage are made from inside the nostrils so there are no visible scars. Some surgeons believe that this technique also reduces the time required for healing.
Why wouldn’t every case be performed in a closed fashion? For one thing, the operation is conducted through narrow openings with a more limited view which makes it a bit more challenging. Secondly, there are certain maneuvers that most experienced surgeons believe can ONLY be accurately performed with the better exposure provided by the open approach.
What is An Open Rhinoplasty?
External rhinoplasty or open rhinoplasty uses the same incisions as the closed rhinoplasty except that the incisions on either side are connected with an incision across the columella (the skin between the nostrils). So the difference between the two approaches is an incision that is 1/4 inch long! Open rhinoplasty allows the surgeon to complete visualization of the nasal structures, including any distortions of your cartilages, bones, and septum. Having this access should give the surgeon more control over the nasal reshaping or reconstruction. There is a permanent scar across the columella but it almost always fades away to almost invisible over time.
Some surgeons use the open approach for every case while others restrict the use to patients who have had previous surgery or who have specific problems that require repair.
During the consultation, your plastic surgeon will consider your concerns, your skin type, and the maneuvers that he/she believes will be necessary to accomplish the result. Based on those factors the surgeon will recommend an open or closed procedure.
While all rhinoplasties can be performed through the open approach, most experienced rhinoplasty surgeons do not think that the closed approach is applicable to every nose.
So, if you are a candidate for rhinoplasty or would like to learn more about it, set up an appointment with Dr. Thorne. You can also arrange a virtual consultation with him here. He is an expert in rhinoplasty and has performed rhinoplasty procedures for more than three decades. He has also taught and authored several plastic surgery books.