Doctors agreed: only remove dorsal hump - conflicting consults w/open vs closed. Closed pros: no scar, no tip disruption, great pis of tricky closed nose job from closed recommending dr. (unsure of post-surgery date on pics). Closed cons: Bones can move/won't be stable structures if not cut in right place, bone above nose is a little narrow, may need graft post-op if it narrows. Open pros: more visibility to make exact cut/angle bone to prevent open roof deformity. Open con: scar; tip disrupt.
Answer: Open Versus Close Rhinoplasty There is no question that an open technique is superior. I did closed rhinoplasty for the first 10 years of my practice and have been doing mostly open rhinoplasties for the last 25 years because the result are more precise and more predictable. We do even see the tiny scar on the columella in most patients. It is extremely rare to have a rhinoplasty patient who only needs a hump removal only. Most patients have flaws in the tip or other sides that would make the open rhinoplasty more logical. Closed rhinoplasty is not wrong, it is less than ideal for most noses.
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Answer: Open Versus Close Rhinoplasty There is no question that an open technique is superior. I did closed rhinoplasty for the first 10 years of my practice and have been doing mostly open rhinoplasties for the last 25 years because the result are more precise and more predictable. We do even see the tiny scar on the columella in most patients. It is extremely rare to have a rhinoplasty patient who only needs a hump removal only. Most patients have flaws in the tip or other sides that would make the open rhinoplasty more logical. Closed rhinoplasty is not wrong, it is less than ideal for most noses.
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Answer: Ultimately, it's the surgeon's preference. In the last 30 years, there has been a strong movement among experienced rhinoplasty surgeons towards open rhinoplasty, because of the advantages of correcting underlying asymmetries and making subtle refinements in shape or structure under direct vision. Open roof deformities should be rare with either closed or open rhinoplasty. I performed closed rhinoplasty exclusively early in my career, but over the last 20 years have evolved towards open rhinoplasty, which I now perform over 95% of the time, reserving closed rhinoplasties for patients in which I am making minimal or no changes to the tip. Nevertheless, there are still excellent surgeons who prefer closed rhinoplasties, and there is no one right way to do a rhinoplasty. The scars are virtually never an issue for the patients, and with meticulous dissection, tip swelling is a minor issue. I liken the analogy of an open rhinoplasty to opening the hood when working on the engine, versus working only from underneath. There is more that one can do, in terms of reshaping, with sutures and precise placement of grafts. Performing osteotomies can be done well through either approach, open or closed.
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Answer: Ultimately, it's the surgeon's preference. In the last 30 years, there has been a strong movement among experienced rhinoplasty surgeons towards open rhinoplasty, because of the advantages of correcting underlying asymmetries and making subtle refinements in shape or structure under direct vision. Open roof deformities should be rare with either closed or open rhinoplasty. I performed closed rhinoplasty exclusively early in my career, but over the last 20 years have evolved towards open rhinoplasty, which I now perform over 95% of the time, reserving closed rhinoplasties for patients in which I am making minimal or no changes to the tip. Nevertheless, there are still excellent surgeons who prefer closed rhinoplasties, and there is no one right way to do a rhinoplasty. The scars are virtually never an issue for the patients, and with meticulous dissection, tip swelling is a minor issue. I liken the analogy of an open rhinoplasty to opening the hood when working on the engine, versus working only from underneath. There is more that one can do, in terms of reshaping, with sutures and precise placement of grafts. Performing osteotomies can be done well through either approach, open or closed.
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March 9, 2016
Answer: Limiting rhinoplasty surgery to hump removal may lead to droopiness of your tip postoperatively. In many patients, their dorsal hump may involve the lower cartilaginous bridge. When hump removal is performed with either an endonasal or an external approach, the supporting ligaments from your bridge to your tip cartilages may be severed. Maneuvers may be necessary to ensure your tip remains supported after hump removal to prevent tip droopiness postoperatively.In general, the approach is less important than what is done to the underlying bone and cartilage of your nose during rhinoplasty surgery.Feel free to re-ask your query with photos.Hope this helps you.Dr Joseph
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March 9, 2016
Answer: Limiting rhinoplasty surgery to hump removal may lead to droopiness of your tip postoperatively. In many patients, their dorsal hump may involve the lower cartilaginous bridge. When hump removal is performed with either an endonasal or an external approach, the supporting ligaments from your bridge to your tip cartilages may be severed. Maneuvers may be necessary to ensure your tip remains supported after hump removal to prevent tip droopiness postoperatively.In general, the approach is less important than what is done to the underlying bone and cartilage of your nose during rhinoplasty surgery.Feel free to re-ask your query with photos.Hope this helps you.Dr Joseph
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March 10, 2016
Answer: Closed vs. Open Approach Thank you very much for your question.As you can see, different surgeons will have different opinions regarding the approach. I think the best approach is to find a doctor whose results you like, and in whom you have confidence to deliver the result you desire. And then let them pick the closed vs. open technique. Best of luck!
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March 10, 2016
Answer: Closed vs. Open Approach Thank you very much for your question.As you can see, different surgeons will have different opinions regarding the approach. I think the best approach is to find a doctor whose results you like, and in whom you have confidence to deliver the result you desire. And then let them pick the closed vs. open technique. Best of luck!
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March 9, 2016
Answer: Open or closed? Doesn't matter. I won't even tell you what I prefer. Here's how you pick open vs. closed. First, you find a doctor who has great results working on noses like yours. If he passes all the tests about how to find a good rhinoplasty doctor that I list in the "Web reference" link below, then you've found your surgeon, and you let him do open or closed, whatever he thinks will work best for you in his hands!
Helpful 1 person found this helpful
March 9, 2016
Answer: Open or closed? Doesn't matter. I won't even tell you what I prefer. Here's how you pick open vs. closed. First, you find a doctor who has great results working on noses like yours. If he passes all the tests about how to find a good rhinoplasty doctor that I list in the "Web reference" link below, then you've found your surgeon, and you let him do open or closed, whatever he thinks will work best for you in his hands!
Helpful 1 person found this helpful
