I had closed rhino and many of my friends had theis open. Why. Wat is the disadvantage.
What's the Disadvantage of Open Rhinoplasty?
Doctor Answers (11)
Open rhinoplasty disadvantages
Open rhinoplasty definitely results in more swelling and of course a small external scar. However, the external scar heals so well in the majority of cases that after a few weeks, it is almost imperceptible, In addition, the access obtained by doing it open gives amazing access to allow for precision that in my opinion can not be achieved in most closed rhinoplasties.
What's the Disadvantage of Open Rhinoplasty?
The reason to perform an Open Rhinoplasty IMHo depends on some compelling factor in the nasal tip...
- prior tip surgery that's now asymmetric
- very wide tip that's under rotated
- lost tip support that requires a cartilage shield graft that should IMO be sutured or glued into posiition.
For over 22 years these are the reasons that I use open versus closed Rhinoplasty but every Rhinoplasty Surgeon has his or her own reasons.
Open rhinoplasty scar.
There are surgeons who say that the open leaves a noticeable scar--this is not correct. The scar is the easiest part of the procedure. As one of 4 pioneers of the open technique 37 years ago, I was routinely told you could get the same result closed. Some noses can be done closed with excellent results and others need the open technique. The main disadvantage of open rhinoplasty is that the lower third of the nose stays swollen slightly longer, but not noticeable>
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In experienced hands, both open and closed rhinoplasty give a surgeon options to achieve the desired outcome. An open rhinoplasty will leave a scar in the columella, which is usually imperceptible when healed. Also, an open rhinoplasty may have a slightly longer time of tip swelling.
Small Disadvantages of Open Rhinoplasty
As a board certified plastic surgeon and board certified ENT I find the benefits of the open rhinoplasty out weigh the disadvantages. The disadvantages are a small scar, which generally becomes imperceptible and a small amount of swelling and numbness in the columella which also goes away. Patients generally feel these small disadvantages are acceptable.
The advantages of the open technique far outweigh the disadvantages. The disadvantages are as follows:
- Small incision between nostrils (which typically heals well)
- More tips swelling
- More tip numbness
Disadvantages of open rhinoplasty.
Open rhinoplasty has 2 major disadvantages when compared to the closed approach: 1) the presence of a small scar across the columella and 2) more prolonged swelling and firmness of the nasal tip. The columellar scar will eventually heal and be essentially invisible if done properly and the tip swelling and firmness will eventually subside. The advantages of open rhinoplasty, however, far outweigh these disadvantages and provide for a better chance of a 'home-run' during the first surgery in all but the simplest rhinoplasty cases.
Open rhinoplasty has some disadvantages
Two disadvantages from an open rhinoplasty are increased tip stiffness and swelling, and of course the external scar. We perform open and closed rhinoplasty, as most experienced rhinoplasty surgeons do. One is not better, but the approach is determined by the individual need.
The main DISadvantage of external or "open" rhinoplasty is swelling. This is fortunately temporary.
The main DISadvantage of external or "open" rhinoplasty is swelling. This is fortunately temporary. As my colleagues have already mentioned, the incision if properly placed and sutured closed is not typically noticeable beyond a couple of weeks.
Swelling, on the other hand, is typically more pronounced than with the endonasal or "closed" technique. Careful surgical technique and taping of the nose after surgery can help but most patients will notice swelling. The majority of this swelling is gone by 6-12 weeks but I try to prepare my patients for this. Especially when the procedure is being performed to refine or reduce the nose, the swelling can cover up all of the meticulous work underneath this surface. This will all be revealed when the swelling resolves, so be patient.
Thank you for your question.
Stephen Weber MD, FACS
Closed rhino there is no scar on the columella, open there is ofter a visible scar ( although proponents of open say the scar is invisible). I have 35 years of experience doing rhinoplasties and about 95% are done closed with no scars on the columella. The younger plastic surgeons are taught to do it open.
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