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All About Open vs. Closed Revision Rhinoplasty

If you are considering revision rhinoplasty, you may be wondering which type of procedure best suits your needs

The distinction between external (open) and endonasal (closed) rhinoplasty is the placement of the incision. Open rhinoplasty is a technique that involves making a small incision across the columella, the soft tissue between the nostrils, while the incisions made during closed rhinoplasty are within the nostrils. A number of factors should be taken into account when determining which technique is most suitable, including the extent of the correction needed, your goals for the procedure, and the area of the deformity being corrected. The pros and cons of each procedure are outlined below.

Revision rhinoplasty can help you achieve your desired results

Pros of open rhinoplasty

As a result of the small incision made across the columella during open rhinoplasty, the nasal skin can be folded back or “opened up”, providing the surgeon with clear access to the cartilage and tissues of the nose. The greater visibility of the nasal skeleton provided with open rhinoplasty means that it is a more precise technique and there is a reduced risk of distortion of the nasal cartilage. It is an excellent option for revision rhinoplasty, because it allows the surgeon to safely and precisely access and adjust the nasal tip, which may have been damaged during primary rhinoplasty. Since many revision rhinoplasty procedures require the use of grafts or implants to replace damaged or missing cartilage, open rhinoplasty is often the best option to ensure optimal results.

Cons of open rhinoplasty

Open rhinoplasty is a more invasive surgery than closed rhinoplasty, meaning that the procedure and recovery typically take longer. While most swelling dissipates within the first 2 weeks, minor, residual swelling may persist for 6 months or longer following the procedure.

The small trans-columella incision that is required for open rhinoplasty will leave a faint scar, which may bother some patients. However, when performed by an experienced surgeon, the resultant scar is often invisible in as little as 6 months.

Secondary rhinoplasty can repair a bent or broken septum to improve your breathing

Pros of closed rhinoplasty

Closed rhinoplasty is a less invasive procedure as a result of the specialized technique used. Consequently, the procedure and recovery time are both reduced. While patients will experience swelling, it often resolves itself completely 2 weeks post-operatively.

Since the incisions are made inside the nostrils, they are hidden out of sight, and there is no risk of scarring along the columella.

Cons of closed rhinoplasty

Unlike open rhinoplasty, which allows the surgeon excellent visibility of the nasal structures to perform meticulous repairs, closed rhinoplasty is conducted by feel without the open visibility. As a result, it has considerable limitations for revision because the surgery is performed through narrow, internal surgical openings. To access the nasal framework and manipulate tough scar tissue, the nasal skin will be stretched, and there is a risk that nasal cartilage may be distorted.

Both techniques have advantages and disadvantages for primary procedures, depending on the aesthetic goals. What is suitable for one patient might not be best for another. For detailed revision work, an open approach is often preferred. During your consultation, Dr. Torgerson will evaluate your needs and clearly present all available options so you can decide the best course of action.

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