Open Rhinoplasty Vs Closed Rhinoplasty : An In Depth Comparison

Rhinoplasty also known with the name *nose Job* refers to surgical procedure involving improving the shape and size of the nose making it look better than before. Rhinoplasty corrects the deformities of nose, deviated septum, breathing difficulties and any injuries caused.

Two kinds of techniques are used under rhinoplasty i.e. open and closed rhinoplasty. Results from rhinoplasty generally take time to become apparent because of swelling. As the tissues settle and the swelling goes down, it could take a few weeks or even months before the final result is visible. After the initial healing period, patients can typically see a noticeable change in the way their nose looks and functions.

Rhinoplasty Techniques: Selecting the Best Method for Open vs. Closed Rhinoplasty

Open Rhinoplasty
The columella is the tissue strip separating the nostrils, and during an open rhinoplasty, the surgeon makes an incision along it. This incision enables the surgeon to lift the skin and gain direct access to the nasal tissues beneath. The surgeon then delicately reshapes the soft tissues, cartilage, and bones of the nose to produce the desired alterations in appearance and functionality. Grafts can be used to strengthen or improve the form of the nose. After the adjustments are finished, the skin is re-draped, and the wounds are stitched shut.

Advantages

1. Visibility And Accuracy
Under open rhinoplasty, the visibility of the nasal anatomy is more useful for cases where more structural changes are needed. This results in making the process easier and accurate.

2. Revision Rhinoplasty
In cases where revision rhinoplasty is required, open rhinoplasty is given the preference in most of the cases. The enhanced access to the underlying structures provided by the open approach enables the surgeon to address and undo the previous surgical modifications more successfully.

3. Placing Grafts
Compared to closed rhinoplasty, open rhinoplasty offers easier access for the insertion of grafts. Improved nasal shape, structure, and support may be achieved with the use of grafts such cartilage or bone. The open technique improves overall outcomes and long-term stability of the nose by enabling the surgeon to precisely position and anchor grafts.

4. Precise Modifications
Enhanced visibility results in making the modifications of tissues, nasal bones, cartilage easier and precise. For patients who need considerable contouring or correction of structural defects, this level of precision is extremely crucial.

Drawbacks

1. Visible Scarring :- Since the open approach necessitates an incision along the columella, a small external scar may be left behind and be noticeable, especially during the initial stages of healing. However, with the right techniques, scarring may frequently be reduced and made gradually less noticeable.

2. Extreme Swelling :- Extreme swelling can be there after open rhinoplasty especially in the tip area as compared to closed rhinoplasty.

3. Prolonged operation :- In comparison to closed rhinoplasty, the operating time of open rhinoplasty takes longer. The hazards of anesthesia and surgery can rise as the length of the operation increases.

Closed Rhinoplasty

Incisions are only made inside the nostrils during a closed rhinoplasty; no external incisions are made. Through these interior incisions, the surgeon gains access to the nasal structures and makes the required adjustments. The benefit of this method is that because all incisions are made inside the nostrils, no visible scars are left behind. To obtain the desired alterations, the surgeon reshapes the nasal bones, cartilage, and soft tissues. Although access and visibility for graft insertion are less favorable in closed rhinoplasty than in open rhinoplasty, grafts may still be employed.

Advantages
1. No External Scarring :- Due to the fact that all internal incisions are performed, one of the closed technique’s main advantages is the lack of an outward scar. Patients who worry about obvious scarring may find this to be especially appealing.

2. Quick Recovery :- Due to less swelling, the recovery from closed rhinoplasty doesn’t take much time. As a result, patients might recuperate more quickly and resume their regular activities sooner as compared to open rhinoplasty.

3. Best for Simple Cases :- Closed rhinoplasty is frequently appropriate for patients who only need small adjustments to the contour of their noses without major changes to the nasal anatomy. For those with uncomplicated aesthetic objectives or little functional concerns, it is very helpful.

Drawbacks

1. Limited Visibility
The closed technique limits the surgeon’s direct view of the nasal structures, making it more difficult to make accurate adjustments. This method is frequently seen as being appropriate for simpler scenarios that only call for modest adjustments rather than significant structural alterations.

2. Difficulty in Graft Placement :- Due to the restricted access and diminished sight during closed rhinoplasty, graft placement can be more difficult.

Choosing Best Technique

The choice between open and closed rhinoplasty is based on a number of variables, including the patient’s individual requirements and the surgeon’s level of experience. It is essential to have an extensive consultation with a licensed and skilled plastic surgeon who can evaluate your unique condition and suggest the best procedure.

For complicated instances needing major contouring, extensive changes to the nasal framework, or revision treatments, open rhinoplasty is often preferred.

Patients who want to make slight adjustments to the form of their noses without significantly changing the nasal structure frequently find closed rhinoplasty to be an effective procedure. This method appeals to people with basic aesthetic goals in particular because there are no outward scars.