The Difference Between Open & Closed Rhinoplasty – –
Board certified plastic surgeon Dr. Ali has performed hundreds of rhinoplasty surgeries – giving women and men the beautiful and natural looking noses that they love!
But, as with any surgery, an incision does have to be made during rhinoplasty – in order to access and modify the cartilage that shapes the nose. So, one of the primary concerns that Dr. Ali’s patients have is the degree of scarring they may experience after a nose job.
The type of surgical technique that is used to perform the rhinoplasty will determine where and what type of scarring may be possible. And, every person’s skin heals slightly differently.
However, in the hands of a skilled board certified plastic surgeon like Dr. Ali, the potential for visible, lasting scars is greatly reduced – while ensuring the most attractive and natural nasal contour. Additionally, modern advancements in surgical technology have made surgical procedures much less invasive – reducing the degree of scarring greatly.
In this article we explain the different types of rhinoplasty surgical techniques, the incisions involved, and the potential for any scarring.
Open vs. Closed Rhinoplasty
“Closed” rhinoplasty is a type of rhinoplasty in which all of the surgical incisions are hidden within the inside of the nostril. This technique is great, since it avoids a potentially visible scar. However, it also significantly reduces the surgical access area for the surgeon, which limits their ability to utilize many of today’s most effective rhinoplasty techniques.
“Open” rhinoplasty, uses a small (4mm) trans-columellar incision, to connect the right and left nostril incisions- which allows the nasal skin to be folded upward. This gives the surgeon much greater access to the nasal structure, enabling them to modify and/or strengthen the skeletal framework using more advanced and complex techniques.
Although the open rhinoplasty incision initially leaves a small visible scar, it is very tiny (4 mm) and it often fades completely in the months following surgery. And, in cases where substantial revisions of the nose are needed, the advantages in contouring gained by the open approach are well worth the limited risk of a tiny scar.
Endonasal Rhinoplasty: A Closed Nose Job
A closed rhinoplasty is also called endonasal rhinoplasty. Parallel incisions encircle nearly half of the nostril lining, but no part of the incision is seen externally. But, because the right and left nostril incisions are disconnected, the entire operation must be conducted through narrow surgical openings which limits access visibility.
Also, because access to the nasal framework requires vigorous stretching of the skin, some distortion of the nasal cartilage is possible. In many cases the considerable challenges and technical limitations of endonasal rhinoplasty makes it an inferior choice – even though it avoids visible scaring.
External Rhinoplasty: An Open Nose Job
An open rhinoplasty is also called an external rhinoplasty. The small bridging incision, (trans-columellar incision) offers the surgeon direct visibility of almost the entire nasal framework. There is no stretching, so distortion of the nasal cartilage is minimize. Most skilled plastic surgeons agree that the small visible columellar scar (which fades over time) is worth the improved accuracy and effectiveness of the open rhinoplasty approach.
For these same reasons, open rhinoplasty is also my preferred approach for primary (non-revision) rhinoplasty since it improves diagnostic accuracy and facilitates precision re-engineering of the misshapen nose. However, the technical demands of open rhinoplasty are rigorous, and substantial dedication and commitment to this approach are required to achieve consistently superior results.
For patients desiring only minor or subtle changes to their nose, a third non-surgical alternative is now available. Dr. Ali is also skilled in the injection of facial fillers to remedy small cosmetic issues in the nose, including smaller bumps, slight asymmetry, etc.
The advantage of a filler or “liquid” rhinoplasty is that there in no downtime or recovery period – other than some slight swelling that dissipates in a few days. And because there are ni incisions, there are no scars and no pain afterwards. However, unlike a nose job – which is permanent – non-surgical “liquid rhinoplasty” results typically last from a year to two years.
Birmingham’s Top Rhinoplasty Surgeon
In the expert hands of a Board Certified Plastic Surgeon, the open rhinoplasty approach often offers technical advantages over closed rhinoplasty. And because the scar is so small and “beneath” the nose, it is not visible from most angles when looking at the face.
But for patients only requiring minor revisions or adjustments to the nose’s structure, closed rhinoplasty may be the best option. And for men and women who only desire minor revisions to the appearance of their nose, non-surgical liquid rhinoplasty with fillers can be an excellent alternative.
Birmingham area board certified plastic surgeon Dr. Ali has helped hundreds of women and men love their noses and improve their confidence with rhinoplasty surgery. Schedule a consultation and take the first step toward getting the nose you have always wanted – and look and feel like the best version of “you” that you can be!