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The closed approach may be appropriate for your situation, but a personal consultation is required to determine if this is the case. There are some types of repair which are better open, and some closed. I understand the desire to avoid an incision if possible, but this needs to weighed against the challenge of the revision needed.
Anything that can be done open can be done closed. I routinely place spreader grafts closed. In fact, the original description of spreader grafts by Dr. Sheen was in a closed approach. The term "closed" in rhinoplasty use a misnomer. The nose ia plenty open during surgery, but there is simply not a skin incision accross e columella.
Yes, spreader grafts and a dorsal augmentation graft can be performed through a closed rhinoplasty approach which avoids the external incision. More important to know is whether there's any cartilage left on the inside of the nose for potential grafting purposes. For more information and many before-and-after examples, please see the link below to our closed rhinoplasty photo gallery
I prefer to perform rhinoplasty using an open technique because I like to secure the grafts under direct vision. Performing them closed does not offer this directly.
Without all views of pre-op and post-op photos and the benefit of physical exam- it's difficult to comment accurately. Discuss directly with your operating Surgeon and you may consider a second opinion from an experienced Board Certified PS with extensive experience in Rhinoplasty
It has been long enough and you can have a revision rhinoplasty at any time. See a very experienced revision rhinoplasty specialist who can discuss your options with you
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