Closed or Open Rhinoplasty Better for Revision?

Question

ive already had an open one. my nose was broken and brought in, my tip turned up and some off of it & bump filed down.The only thing is he added septum cartilage to the top and bottom of bump to make it look straighter which just inturn gave me a bigger nose in height wise which is not what i wanted. also the tip is too upturned and too much off. i preferred my longer nose. would a revision be better with a closed or open since he would just have to file it down more and add back on the tip?

Ali Sajjadian, MD, FACS · Answer

Both Open and Closed Rhinoplasty Techniques and Approaches can be used. The choice of technique depends on several factors including the extent of the correction needed, the degree and location of the deformity, your expectations and the rhinoplasty surgeon's preference.

	Most importantly, you should choose your surgeon carefully. Revision Rhinoplasty is a challenging procedure. You would be best served by someone who has  passion for this procedure and has extensive training in all aspects of nasal surgery. Make sure that you are confident in their ability and skills. You want this to be your last procedure!

	Hope this was helpful.

	Dr. Sajjadian

Sam Naficy, MD, FACS · Answer

The open rhinoplasty approach is typically the approach of choice for complex primary and revision Rhinoplasty and allows for both proper diagnosis and precise correction of deformities

Siamak Agha, MD, PhD, FACS · Answer

It really depends on what corrections are needed, as well as your surgeon's preference. Since you have already had an open procedure, I would personally do an open rhinoplasty revision again. This will give the surgeon my control.

Scott Trimas, MD · Answer

In my opinion, if the revision is extensive in nature and requires a lot of grafting and additional surgery, it is best to have an open approach so that previous areas can be addressed without guesswork. That being said, for more limited revisions, we often will do a closed approach. The most imortant question to ask is what is being done and how the surgeon can specifically address the issue being corrected. I hope this information helps.

Etai Funk, MD · Answer

Both approaches are appropriate depending on the surgeon's comfort with that method. An open approach for revision surgery deals with more scarring and a more difficult dissection, but allows better visualization and placement of cartilage grafts. There is slightly more swelling after surgery with an open approach. If a small hump needs to simply be filed down more, a closed approach may be appropriate. There is less swelling after surgery with the closed approach.

Ira D. Papel, MD · Answer

In a complex case such as you describe, and with a history of already having an open procedure, the open techniques are most likely to give you some resolution of your concerns.

Steven Wallach, MD · Answer

I think that a revisoin is often best done by opening the nose.  Opening the nose provides better visualization of the soft tissues and nasal framework.

Jay M. Pensler, MD - Account Suspended · Answer

The issue should not be the technique used but rather the experience of the surgeon . I personally utilize different techniques in different situations.

Richard W. Fleming, MD (retired) · Answer

Most good rhinoplasty surgeons, using both open and closed approaches, apply these techiques based on their own personal experience. Pick the surgeon, not the surgical procedure. Find an excellent, experienced revision rhinoplasty surgeon and follow his/her recommendations.

Closed or Open Rhinoplasty Better for Revision?

Answers (9)

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