In order to perform a rhinoplasty, a surgeon temporarily elevates the nasal skin in order to gain access to the underlying bone and cartilage supporting structures. As with any surgical procedure, patients and doctors have several options to consider. A key question to discuss in this case is the difference between closed and open rhinoplasty. Understanding the distinctions can help a patient and the doctor’s determination as to which choice is the optimal for the clinical issue.
Also known as endonasal rhinoplasty, a closed rhinoplasty is designed such that all incisions are made within the patient’s nostrils. In spite of the fact that parallel incisions can be found around about half of the lining of the nostril, there are no visible scars associated with this procedure.
The downside of closed rhinoplasty is that the surgeon must do all of the work through extremely narrow nasal openings with limited visibility. In addition, due to the fact that most of the procedure is performed through limited visualization during the procedure a great deal in the process, it is almost inevitable that there will be a sub-optimal “fine tuning” of the cartilage. For many cases, this is not a critical issue. However, if a more detailed repositioning of the nasal cartilage is critical to providing an optimal result, an open rhinoplasty may be a better pathway for the nasal surgery.
As its name suggests, an open rhinoplasty does not take place within the nostrils. Instead, a small “bridging” cut called a trans columella columnar incision is made to connect the incisions in the left and right nostrils. The trans columella incision measures between 4 and 5 mm and is usually, barely visible, but this type of surgery does have its benefits. Most notably, the surgeon can simply elevate the skin off the nose, which provides him greater visibility of the nasal bones and cartilage allowing him or her to gain almost total visibility of the inner framework of the patient’s nose.
With this surgical option, by seeing more of the structures that need to be treated to provide the patient their desired goal, the surgeon can provide a more precise surgical result. In addition, each aspect of the nose can be evaluated in its undisturbed state.
During your rhinoplasty consultation with Dr. Kulick, you will discuss your unique cosmetic situation and how it can best be corrected. You will discuss the comparative benefits of the different techniques used during a rhinoplasty procedure. In general, you will be weighing the cosmetic advantages against the required techniques needed to achieve your desired result by using these methods. Dr. Kulick has been able to correct the mishaps of patients that were not happy with their initial rhinoplasty performed by other doctors.
If you have been looking for a way to correct a misshapen nose or transform your appearance to be more aesthetically pleasing, cosmetic surgery may be exactly what you have been looking for. Successful rhinoplasty surgery, whether closed or open, can change your entire outlook on life. In the capable hands of an experienced surgeon, you can be liberated from the discomfort and damage to your self-esteem that often accompanies facial deformities and disfigurements.