Often one of the most confusing questions when confronted by a rhinoplasty patient is prospective rhinoplasty with a choice of open versus closed rhinoplasty.
This portrayal often results in puzzling looks from patients. Since virtually all changes to the outer nasal contour result from corresponding changes to the nasal skeleton, the surgical approach, and the corresponding skeletal exposure it provides, has a direct bearing on the ease of surgery and thus, the quality of the rhinoplasty outcome.
Endonasal Rhinoplasty: The Closed Approach
In the closed rhinoplasty approach, also called endonasal rhinoplasty, all of the surgical incisions are positioned inside the nostrils such that no part of the incision can be seen externally and a visible scar is avoided.
Since the right and left nostril incisions remain disconnected, respositioning the nasal skin is difficult. And what makes it even more challenging is the entire operation is performed through narrow surgical openings with reduced visibility. With that being said, many physicians find the endonasal approach to be quit be quite useful in certain situations including when bridge augmentation or minor bridge refinement is performed.
Open Rhinoplasty Approach
Open rhinoplasty involves a small incision placed in the columella (the skin at the bottom of the nose between the two nostrils). This incision allows wide exposure and assessment of the nasal cartilages and bones, and is closed with tiny sutures without tension so as to promote healing.
Which is best for you?
There is a lot of opinion out there about which approach to rhinoplasty is better. The truth of the matter is that best approach is a patient-specific approach – your surgery should be planned and performed in the way that gives you the best result.
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