The difference between open and closed rhinoplasty

Introduction

Today, rhinoplasty or Nose Job is one of the most challenging and common surgeries to enhance facial beauty in the world, which requires a proper understanding of the anatomy of the nose with a focus on improving the appearance and function of the nose.
Technically, rhinoplasty is to change the shape of the nose or improve its function, such as medical problems that are performed to solve respiratory problems, and ultimately, aesthetically, can change the shape and appearance of the nose.
In rhinoplasty, the surgeon first lifts the skin of the nose and makes changes to the bone and cartilage, lowering the skin again. One of the confusing problems in rhinoplasty is deciding which methods and techniques to use to achieve the desired result, and this is important because patients need to be aware of the procedure and the options available to them to be able to make the best decision for their health and beauty.
There are two different methods for reshaping the tip of the nose: open rhinoplasty and closed rhinoplasty. Each method has its advantages and disadvantages that the patient can consult with his doctor before surgery.

Closed Rhinoplasty:

Closed rhinoplasty was the first method of rhinoplasty that is still widely used by many surgeons. In this procedure, small incisions are made inside the nostrils, and the surgeon makes changes to the nose through the nostrils without lifting the skin. Although parallel incisions surround almost half of the nostril cover, no part of the incision is seen outside the nose, which prevents visible scarring.
In this procedure, the skin of the nose is difficult to reposition, and the entire operation must be performed through narrow surgical openings with limited vision. Access to the nasal frame also requires intense stretching of the nasal skin, so deviation of the nasal cartilage is inevitable. While this procedure prevents visible scarring, significant challenges and technical limitations are associated with the relative lack of surgical access.

Open Rhinoplasty:

Open nose surgery, also called external rhinoplasty, is the most common type of surgery. The modern approach to open nasal cosmetic surgery focuses on cartilage and the gradual change of cartilage and skeletal framework. It is done by making a small incision on the columella (the soft tissue that separates the nostrils).
In this method, when the patient is under general anesthesia, easy access to the underlying bone and cartilage structure is provided. Unlike closed rhinoplasty, open or external rhinoplasty uses a small bridging incision, called a trans-column incision, to connect the right and left nostril incisions.
In this method, the skin of the nose can be pulled up (similar to opening a car cover) and the lower skeleton of the nose can be seen without obstruction. In addition to the direct vision of almost the entire nasal frame, nasal cartilage tilt is minimized and individual components can be assessed in their natural alignment without disturbance. Therefore, the characteristic of an open rhinoplasty is the very access of the surgeon, which is made possible by the incision under the nose.

In this method, the entire nasal frame can be visualized and reconstructed if necessary. It also enhances the ability to directly visualize ongoing surgical tricks and procedures, and not only increases diagnostic accuracy and correction of abnormalities but also facilitates the training and participation of team members. Swelling) increase the potential and prolong the surgery time a little and cause instability of the cartilaginous framework.
Before performing this type of surgery, some components of the patient’s surgical history need more attention, such as pre-existing allergic disorders, stimuli of the patient’s arteries and nasal mucosa, trauma to the nose, previous nasal procedures, breathing problems (For example, asthma or cystic fibrosis) and sinus pathology.
Although many unattractive aspects of the nose can be corrected with closed nasal cosmetic surgery, the advent of open nasal cosmetic surgery can revolutionize the treatment of complex nasal abnormalities such as cleft lip surgery, nasal torsion, or alteration or severe changing of nose shape, after rhinoplasty. Most rhinoplasty specialists consider open nose surgery to be a better choice for difficult nasal anatomy, and many of the most effective contemporary rhinoplasty techniques can only be performed through the open method.

Advantages and disadvantages of open rhinoplasty

Advantages:

Because the structure of the nose is so obvious, the surgeon has better access to the underlying structure and therefore has more freedom in shaping the nose to the patient’s liking.

Stabilization of the nose after surgery in an open rhinoplasty is easier than closed rhinoplasty. Most surgeons perform rhinoplasty open. Therefore, your chances of finding a suitable surgeon for rhinoplasty are higher.

Disadvantages

Open rhinoplasty also has its drawbacks. The main disadvantage of an open rhinoplasty is that it is longer and more aggressive than closed rhinoplasty, so recovery time is slightly longer and it takes longer to eliminate swelling and bruising. A very small wound may remain on the columella of your nose, although this scar can only be seen if the head is bent backward./Satisfaction after rhinoplasty

Advantages and disadvantages of closed rhinoplasty

Advantages:

Rhinoplasty is a minimally invasive closed surgery that leaves no scar after surgery and causes less swelling and bruising, so the recovery time and surgery time are shorter.

Disadvantages:

Because the surgeon’s vision in rhinoplasty is low and changes to tissues and cartilage in closed rhinoplasty are limited, the surgeon can make limited changes with less finesse. The number of surgeons skilled in closed nasal surgery is less than open nasal cosmetic surgery. Incisions made in the nose weaken the structure of the nose and destroy the stability of the shape of the nose in the future. During the operation, the cartilage of the nose is more likely to tilt because access to the nasal frame requires intense stretching of the skin.

Recovery time for open and closed rhinoplasty

Because closed nose surgery is less invasive than open surgery, the surgery will cause less bruising and swelling, and the nose will heal faster, and some patients may not even have bruising after surgery. Therefore, recovery time in closed nose surgery is faster than open nose surgery, and patients usually need less time to return to normal life.

The difference between open and closed rhinoplasty

The main difference is that while open rhinoplasty is a type of rhinoplasty to correct functional or rhinoplasty problems that are performed by making an incision in the soft tissue between the nostrils (columella) and lifting the skin of the nose, close rhinoplasty It is done for this purpose, but with the difference that all the incisions made inside the nostrils without removing the skin of the nose.

Cost of open and closed rhinoplasty

Since rhinoplasty requires more skill, and fewer surgeons perform the procedure, it usually costs more than a regular open rhinoplasty. While the duration of open nose surgery is longer than the closed method because the second method is more complex and difficult and is often not of interest to surgeons. This is why some rhinosurgeons charge patients more for closed rhinoplasty.
Considering that Iran is superior to other countries in the field of cosmetic surgeries, especially in rhinoplasty, in terms of price, cost-effectiveness, and having skilled and experienced specialists. In this regard, Moj Aramesh Amitis Company, by providing services in the field of cosmetic surgeries such as rhinoplasty (open and closed rhinoplasty) can advise dear patients and guide them in choosing the best rhinoplasty surgeon, because experienced specialists work in this field professionally and cooperate with Moj Aramesh Amitis Company and help patients in this field to achieve their desired result.

Written by: S.Hajizadeh

Translated by: N.Rahimifar