In my 1st rhino, my doctor placed a columellar strut which makes my nose tip appear way too short and too upturned and narrow. I am looking to rebuild my tip and especially want to make my nose longer again. A doctor that I am considering for my revision only does closed rhinoplasties. I am nervous that this will not allow for the best result possible due to limited visibility. Is this something I should be concerned about? Would an open approach be better for what I am looking to have done?
Answer: Revision rhinoplasty... There are experts at both open and closed rhinoplasty, so whichever technique the surgeon is more comfortable will probably suit you best. The key is to determine if the surgeon actually performs many revision rhinoplasty and to look at some photos. Then you can be comfortable that a good job will be done. It is difficult to derotate an over rotated nose.
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Answer: Revision rhinoplasty... There are experts at both open and closed rhinoplasty, so whichever technique the surgeon is more comfortable will probably suit you best. The key is to determine if the surgeon actually performs many revision rhinoplasty and to look at some photos. Then you can be comfortable that a good job will be done. It is difficult to derotate an over rotated nose.
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August 31, 2017
Answer: Open Approach for Major Revision Although I perform both closed and open rhinoplasty, there is no doubt that an open approach for many revisional changes is far superior to closed. Due to scarring contractile forces that may be present from the first surgery, a good structural platform should be created and there is no doubt that visualizing the perfect platform directly is best. Although there are no photos to comment on, the issues that you describe often require several stable cartilage grafts in the form of extended spreader grafts with a septal extension graft, or any one of several other options which lengthen and derotate the nose.
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August 31, 2017
Answer: Open Approach for Major Revision Although I perform both closed and open rhinoplasty, there is no doubt that an open approach for many revisional changes is far superior to closed. Due to scarring contractile forces that may be present from the first surgery, a good structural platform should be created and there is no doubt that visualizing the perfect platform directly is best. Although there are no photos to comment on, the issues that you describe often require several stable cartilage grafts in the form of extended spreader grafts with a septal extension graft, or any one of several other options which lengthen and derotate the nose.
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July 7, 2024
Answer: Revision rhinoplasty to rebuild the tip- closed or open approach? The closed versus open approach is simply just the approach, not what is performed on the inside of the nose. The closed approach avoids the external incision. The experience of the surgeon matters much more than whether or not it's an open or closed approach. A columellar strut, additional cartilage grafting can all be done with either closed or open approach. For many examples of revision rhinoplasty with a closed approach, please see the link and the video below
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July 7, 2024
Answer: Revision rhinoplasty to rebuild the tip- closed or open approach? The closed versus open approach is simply just the approach, not what is performed on the inside of the nose. The closed approach avoids the external incision. The experience of the surgeon matters much more than whether or not it's an open or closed approach. A columellar strut, additional cartilage grafting can all be done with either closed or open approach. For many examples of revision rhinoplasty with a closed approach, please see the link and the video below
Helpful 1 person found this helpful
August 31, 2017
Answer: An open approach by an experienced rhinoplasty surgeon! Rhinoplasty is known to be a very difficult operation to do consistently well. There is no debate about this! Over the years, there has been a lot of debate about closed vs. open approach to rhinoplasty without anyone really clarifying why you would only offer one approach. The benefit of a closed approach is simply not making an incision along the columella and not having a scar there. If there is no difference in what a surgeon would do between open and closed technique, why would anyone do it open? However, if there is much more that can be done with more precision using an open approach, why would a surgeon not want to use the open technique? In my opinion, it's important to do as much with precision as possible, and, therefore, I almost always do an open technique because I know I can do a lot more. The columellar scar is not noticeable and is a good trade to being more precise. Now, why do surgeons offer only a closed technique? I think it's because performing an open approach is technically much more challenging. If a surgeon does not have the proper experience and judgment and technique with an open approach, it can turn out badly. I would advise you to get another opinion by a board certified plastic surgeon, who has a lot of experience with rhinoplasty and revision rhinoplasty. Good luck!
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August 31, 2017
Answer: An open approach by an experienced rhinoplasty surgeon! Rhinoplasty is known to be a very difficult operation to do consistently well. There is no debate about this! Over the years, there has been a lot of debate about closed vs. open approach to rhinoplasty without anyone really clarifying why you would only offer one approach. The benefit of a closed approach is simply not making an incision along the columella and not having a scar there. If there is no difference in what a surgeon would do between open and closed technique, why would anyone do it open? However, if there is much more that can be done with more precision using an open approach, why would a surgeon not want to use the open technique? In my opinion, it's important to do as much with precision as possible, and, therefore, I almost always do an open technique because I know I can do a lot more. The columellar scar is not noticeable and is a good trade to being more precise. Now, why do surgeons offer only a closed technique? I think it's because performing an open approach is technically much more challenging. If a surgeon does not have the proper experience and judgment and technique with an open approach, it can turn out badly. I would advise you to get another opinion by a board certified plastic surgeon, who has a lot of experience with rhinoplasty and revision rhinoplasty. Good luck!
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August 31, 2017
Answer: Rhinoplasty revision I prefer to perform most of my rhinoplasties using an open approach. Some surgeons prefer a closed approach. Good results can be obtained with both methods. Good luck.
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August 31, 2017
Answer: Rhinoplasty revision I prefer to perform most of my rhinoplasties using an open approach. Some surgeons prefer a closed approach. Good results can be obtained with both methods. Good luck.
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