Like any intervention, rhinoplasty can be performed using different methods. Two techniques exist: the open way and the closed way. Often reduced to their scars, these two methods offer different surgical possibilities, and are much wider open.
Closed rhinoplasty
It is the oldest approach to nose job. We hardly use it anymore
Principle of closed rhinoplasty
We talk about closed rhinoplasty, when the scars are hidden inside the nose.
The majority of technical gestures are visualized indirectly by pulling them to get them out of the nostrils, or blindly at the upper part of the nasal dorsum. The consequence is that the precise anatomy of the nose is analyzed in a restricted way.
As a result, this method is less and less practiced today by specialists in rhinoplasty, because it is the source of numerous technical inaccuracies, in particular in the correction of asymmetry or for the placement of grafts.
Recent works on the subject approach this intervention most often from the “open way”.
On the other hand, closed rhinoplasty is accompanied by less edema than by the open route, especially in the first postoperative months. But in all cases, the swelling eventually subsides.
Open rhinoplasty
More and more, the intervention is carried out by the open technique.
This technique is systematic in complex cases. I mainly use it today, including in patients who have never had a nose job, for maximum technical precision.
Principle of open rhinoplasty
By a small scar on the columella which is prolonged inside the nostrils, the whole of the skin of the nose is raised.
Thus, the entire structure of the tip of the nose and the dorsum can be finely examined in its resting position, without exerting the slightest deformation at this level. The nasal septum is also finely analyzed.
The grafts are sutured in the desired location, and are not just buried like in closed rhinoplasty.
Different type of incisions that look like scars
A small scar is therefore made on the columella, which will quickly fade because it is hidden within a shadowy area of the nose.
Benefits of open rhinoplasty
This procedure has the advantage of offering a very precise analysis of the nasal anatomy. In fact, once the skin has been lifted, the surgeon analyzes the shape of the nose in an anatomical position, without creating any distortion as forced by the closed channel.
Surgical corrections are therefore carried out under optimal conditions, to put all the chances on the patient's side.
Open rhinoplasty is now recommended by the greatest specialists in rhinoplasty, and has become a standard especially in the United States.
Open rhinoplasty scars
They are very discreet and disappear in a few months.
The scar on the columella used for the open approach (center arrow) fades quickly.
It is hidden in a shadow area to make it invisible.
In this case, we also showed the evolution of the reduction scars of the nostrils (right and left arrow).
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