Are Incisions Under the Eyes Necessary During Some Rhinoplasty Procedures?

Incisions underneath the eyes for a rhinoplasty are totally unnecessary. Osteotomies are all performed through tiny incisions inside the nose underneath the sidewall of the bone. Look for a surgeon who can perform a primary rhinoplasty with the closed technique, not open rhinoplasty. A simple reduction rhinoplasty can easily be performed by closed rhinoplasty. This means that all the incisions are placed internally. Busy rhinoplasty surgeons today usually perform between two hundred and three hundred rhinoplasties per year. Look for a surgeon who is board certified in facial plastic surgery and whose original background is ear, nose, and throat surgery or otolaryngology.  

Hello, Boston friend.

Was there recently for the major head and neck surgery convention. Loved the town. Fabulous history. Cute narrow streets. Great food.

Now, getting back to business. Some surgeons do prefer to use tiny chisels, placed through short incisions placed between the side of the nose and the eye area to help crack the nasal bones to narrow them. This is done after the bump is removed. These fine instruments are only 2mm or 3mm wide. Therefore the incisions are very tiny and heal well.

In certain cases where the nasal bones were very thick and refused to narrow using the internal chisel approach, I have done what I believe the professor is recommending. It does work. Healing is excellent particularly when the tiny wounds are closed with one or two very fine stitches. The dissolving kind works beautifully.

Don't sweat that particular technique. The most important issue is: How do the doctors' noses look? Do you like the results you see on his website? In his office " before and after" album? That is really what counts: the results. If you see dozens and dozens of natural-looking noses, you should be comfortable with the doctor. If you are uncertain, then have the doctor do computer imaging to show you the nose he would deliver to you. That is always very important; a meeting of the minds, without guessing about outcome.

Do your homework. Don't mean to brag but my book, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON will help make your research/homework easier. Wrote it for Bostonians and everyone else. Every bookstore has it.

Best wishes to the Patriots!

-Robert Kotler, MD, FACS

 Beverly Hills, CA

There are many ways to correct nasal contour.  The small incisions beneath your eyes I would guess would help the surgeon narrow the nose.  Most surgeons use the internal incision present during rhinoplasty to narrow the nose.  Some surgeons feel more comfortable with one technique versus the other.  The small external incisions are just that VERY SMALL (2 mm) and heal extremely well.  Both techniques are very acceptable.

Dr. ES