Open rhinoplasty is a prevalent technique used in nasal surgery that involves exposing the cartilage of the nose by making a small incision on the columella, the strip of skin between the nostrils. Additional incisions are made inside the nose, typically in a zigzag pattern to minimise visible scarring. This surgical method allows the surgeon to lift the skin and fully visualise the nasal structure, providing greater access to the underlying cartilage and bone.
This article explores the advantages and disadvantages of open rhinoplasty, helping prospective patients make informed decisions by understanding the intricacies of the procedure.
One of the most significant advantages of open rhinoplasty is the superior visibility it offers. By lifting the skin off the nose, surgeons gain a clear and unobstructed view of the nasal anatomy, particularly the cartilage and tip. This enhanced visibility allows for more precise modifications, ensuring that the surgical goals are met with greater accuracy. This can be particularly beneficial in complex cases where subtle adjustments are necessary to achieve the desired outcome.
With better access to the nasal structure, surgeons can refine the nasal tip with greater ease and precision. This is especially important for patients seeking specific aesthetic improvements in the nasal tip, such as reducing its size, altering its shape, or improving its symmetry. Open rhinoplasty enables surgeons to see and feel the cartilage they are working on, allowing for meticulous adjustments that are more challenging with the closed technique.
Open rhinoplasty is often the preferred technique for procedures that require cartilage grafting. Grafting involves using cartilage from other parts of the body, such as behind the ear, to reconstruct or augment the nasal structure. The open approach provides better control over the placement and securing of grafts, reducing the risk of graft displacement and ensuring a more stable and predictable outcome. This is particularly advantageous during a revision rhinoplasty procedure, where previous surgeries may have altered the nasal anatomy.
The open rhinoplasty technique is highly versatile, making it suitable for a wide range of nasal corrections. Whether it involves significant structural changes, correcting asymmetry, or addressing issues from previous surgeries, open rhinoplasty offers the surgeon the ability to tailor the procedure to the specific needs of the patient. This flexibility can lead to more satisfactory and customised results.
While open rhinoplasty offers several significant benefits, it also comes with a set of disadvantages that potential patients should consider. These drawbacks primarily revolve around the longer recovery period, potential for visible scarring, and the more invasive nature of the procedure.
One of the most notable disadvantages of open rhinoplasty is the extended swelling and recovery period. Due to the more invasive nature of the procedure, which involves lifting the nasal skin and exposing the cartilage, there is more surgical dissection required. This leads to increased tissue trauma and, consequently, longer swelling.
Anecdotal evidence from top rhinoplasty surgeons suggests that the swelling can persist for a considerable time, with some patients experiencing residual swelling for up to 24 months. This prolonged recovery period can be a significant consideration for patients who desire a quicker return to normal appearance and activities.
Open rhinoplasty involves making an external incision on the columella, the skin between the nostrils, in addition to internal incisions. While skilled surgeons typically make these incisions in a zigzag pattern to minimise noticeable scarring, the potential for visible scars remains a concern.
Although proper suturing techniques and post-operative care can significantly reduce the appearance of scars, some patients may still have visible marks. This is particularly relevant for individuals who are prone to keloid formation or have a history of poor scarring. In contrast, closed rhinoplasty avoids external incisions altogether, eliminating the risk of visible external scars.
The invasive nature of open rhinoplasty can also impact circulation to the nasal tip. Lifting the skin and manipulating the underlying structures can temporarily disrupt blood flow, leading to impaired circulation. This can contribute to a longer healing process and potentially affect the final aesthetic outcome.
Patients may experience numbness or a tingling sensation in the nasal tip during the initial recovery phase. While these symptoms usually resolve over time as circulation improves, they can be a source of discomfort and concern for patients in the immediate post-operative period.
Open rhinoplasty typically requires a longer surgery time compared to the closed technique. The additional steps involved in making external incisions, lifting the nasal skin, and carefully suturing the incisions at the end of the procedure contribute to this extended duration.
On average, an open rhinoplasty procedure can take a minimum of 2-3 hours, depending on the complexity of the case and the specific modifications required. This longer surgery period can lead to increased bruising and swelling, as well as a more extended overall recovery time. Additionally, the longer time under anaesthesia can be a concern for some patients, particularly those with underlying health issues.
For more information about having a Rhinoplasty consultation, the different types of rhinoplasty, procedure and recovery, visit our Rhinoplasty Page.