Open rhinoplasty surgery is a procedure in which the incision used to access the structures of the nose results in broad exposure of the underlying cartilage and bone. Typically, a small incision is made across the underside of the nose that is then connected to incisions made within both nostrils. The skin overlying the nose is reflected up and off of the structural framework of the nose. This allows the surgeon to have broad visibility of all the components of the nose.
- avg. recovery
About the Procedure
An open rhinoplasty procedure allows for the best visualization of the nasal structures when correcting both cosmetic and functional concerns of the patient. Less invasive techniques such as a closed or endoscopic rhinoplasty afford patients a shorter recovery period and some times more cost-effective option, however, the open rhinoplasty method continues to be widely used for its superior visualization. During an open rhinoplasty, an incision will be made at the columella, just beneath the tip of the nose. The nose will then be retracted backwards, dissecting the nose cartilage with care being taken to not incise the medial crura, the cartilage that separates the nostrils. The flap will be raised off of the nose for maximum exposure and work can now be done to reshape the nasal tip, bridge, nostrils, or septum repair. Once completed, the flap will be redraped over the bone framework and external contouring and shaping is completed. The incision will be closed with sutures and an external splint or cast will be placed over the nose.
The goal of an open rhinoplasty is to achieve facial harmony by changing the shape, size or angle of the nose. Rhinoplasty can also be used to correct breathing problems resulting from irregularities inside the nose.
What to Expect
Open rhinoplasty surgery is a procedure in which the incision used to access the structures of the nose results in broad exposure of the underlying cartilage and bone. Here is a quick guide for what to expect before, during, and after an open rhinoplasty.
- Stop taking blood thinning medications for 2 weeks
- Stop smoking 2 weeks before and after surgery
- Limit sun exposure for 2 weeks
- Do not eat or drink anything 6 hours prior
- Purchase all recovery items beforehand
- General or local anesthesia with sedation
- Incision made beneath the tip of the nose
- Nose is retracted backwards, dissecting the nose cartilage
- Flap is raised off of the nose for maximum exposure
- Nose is reshaped and refined
- Sutures to close incisions
- External splint or cast will be placed over the nose
After an open rhinoplasty, significant facial swelling and bruising is commonly present. An external splint will be applied for one week to give support to the underlying nasal framework. While surrounding swelling of the cheeks and lips will subside after 1-2 weeks, nasal swelling will last as long as a month. The nose itself will continue to heal over the next 1-1.5 years. Makeup may be worn as soon as the cast is removed.
The ideal candidate for an open rhinoplasty has a crooked nose, multiple components contributing to nasal deformity, needs an extensive cartilage graft, or the correction focuses on modifying the nasal tip. Candidates that are undergoing revision rhinoplasties also benefit from an open approach.
Not Recommended For
Open rhinoplasty is not recommended for candidates under the age of 18 unless correction is due to injury, however, need for surgery must be evaluated on a case-by-case basis because children mature physically and emotionally at varying rates.
Side effects from an open rhinoplasty may include numbness, nosebleeds, scarring, swelling, bursting of small blood vessels on the surface of the skin, permanent nerve damage, and under or over correction that necessitates revision rhinoplasty.