Surgical Rhinoplasty : Open and Closed (Reconstructing Nose)

The plastic surgical correction of congenital and acquired abnormalities of the nose restores functional and aesthetic properties by the surgeon’s manipulations of the nasal skin, the subcutaneous (underlying) cartilage-and-bone support framework, and the mucous membrane lining.

Technically, the plastic surgeon’s incisional approach classifies the nasal surgery either as an open rhinoplasty or as a closed rhinoplasty procedure.

In open rhinoplasty, the surgeon makes a small, irregular incision to the columella, the fleshy, exterior-end of the nasal septum; this columellar incision is additional to the usual set of incisions for a nasal correction. In closed rhinoplasty, the surgeon performs every procedural incision endonasally i.e., exclusively within the nose, and does not cut the columella.

Procedural differences
Except for the columellar incision, the technical and procedural approaches of open rhinoplasty and of closed rhinoplasty are similar; yet closed rhinoplasty procedure features:

  • Reduced dissection (cutting) of the nasal tissues — no columellar incision
  • Decreased potential for the excessive reduction (cutting) of the nasal-tip support
  • Reduced postoperative edema
  • Decreased visible scarring
  • Decreased iatrogenic (inadvertent) damage to the nose, by the surgeon
  • Increased availability for effecting in situ procedural and technical changes
  • Palpation that allows the surgeon to feel the interior changes effected to the nose
  • Shorter operating room time
  • Quicker post-surgical recovery and convalescence for the patient

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