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What is Rhinoplasty?

Before undergoing a rhinoplasty procedure, it is vital that patients have a good understanding of what the surgery involves. Otherwise known as a “nose job,” a rhinoplasty consists of a set of surgical enhancements to the nose which are designed to address numerous issues. While rhinoplasty is most often performed to address cosmetic issues, it can provide various medical benefits as well, such as enabling patients to breathe easier.

Reasons for an open or closed rhinoplasty

There are various reasons that one may choose to undergo a rhinoplasty procedure. Many patients have cosmetic concerns that they have struggled with throughout their entire lives. Others develop issues later on due to an injury that has distorted the shape or symmetry of their nose.

These patients often find that their nose:

  • Is not proportionate to the rest of their face (either too big or too small)
  • Has a noticeable bump on the bridge
  • Is a bit too wide for their face
  • Has a tip that is bulbous, protruding, drooping, or over-sized
  • Has overly flared or pinched nostrils
  • Is somewhat crooked or asymmetrical

All of these issues can be treated with rhinoplasty.

Picture of the side of a woman's face, her chin on her arm

Changes made during an open or closed rhinoplasty

All rhinoplasty procedures involve a process of lifting the skin of the nose, making adjustments to the bones and cartilage, and then putting the skin back in place. The artistic aspect of a rhinoplasty procedure lies in the surgeon’s decisions regarding how the bone and cartilage will be altered. As every patient has different nose shapes and concerns, no two procedures are exactly the same.

The benefits of open rhinoplasty

The most obvious benefit of an open rhinoplasty procedure is that the surgeon is able to clearly see all of the underlying layers of the nose. This is just one of many reasons that makes it preferable to most surgeons.

The open approach allows practitioners to easily measure and understand the anatomy of the patient’s nose. This ultimately allows for more precise and detailed work, leaving patients with results that are fine-tuned to their specifications and more natural-looking. While external examinations can give surgeons a good idea of what work needs to be done under the surface, there may be asymmetries and other issues that cannot be perceived without lifting up the skin.

Another advantage is that cases that require cartilage grafts can be addressed much more easily. Cartilage grafting is a delicate procedure that is much better accomplished when the surgeon can see into the treatment area and have wider access to suture the delicate structure of the nose into its final shape and position.

Open, or external, rhinoplasty tends to be more effective for complicated revision rhinoplasty, significant tip reduction, straightening of very crooked noses and augmentation rhinoplasty during which an overly small nose is enhanced.

For the aforementioned reasons, many surgeons prefer to use the open approach.

Disadvantages of open rhinoplasty

On the other side, there are some practitioners who prefer not to use open rhinoplasty. There are usually two reasons that they feel this way.

The obvious one is that the open technique involves a visible scar across the columella. While this scar exists, it usually heals quickly leaving a scar that is often not visible even when you know it’s there. The other reason is that the open technique is associated with an increased level of swelling when compared to the closed technique. While this may be true, the swelling does dissipate over time.

Dr. Weber uses both the open and closed, or endonasal, approach and describes to his patients that the best approach is the one that has the highest likelihood of addressing the patient’s concerns about their nose. Thus, in some cases the advantages that come with the “open” technique greatly outweigh the disadvantages.

The benefits of closed rhinoplasty

Although the open approach comes with notable advantages, there are still many factors that make a closed rhinoplasty the preferred option for many. The consensus amongst surgeons who have performed a massive amount of rhinoplasty procedures is that the closed technique may be preferable when smaller modifications are desired.

While the trans-columellar scar that comes with the open technique is mostly unnoticeable, many patients still find comfort in knowing that the closed technique involves no visible scarring. Furthermore, the closed technique is associated with far less swelling than the open one, meaning that patients will be able to see the final results of the treatment sooner. If it is determined that the patient’s operation can be carried out with the closed technique, it is a good idea to learn more about what it will entail.

Closeup of a woman's nose and mouth

Why is Dr. Weber the right choice for my revision rhinoplasty?

Highly revered for his precision and remarkable results, Dr. Stephen Weber has been providing patients in the greater Denver area and across the United States with superior cosmetic care for more than a decade. A graduate of Boston University School of Medicine, he developed a strong interest in Facial Plastic and Reconstructive Surgery early on and went on to partake in a highly sought after five-year residency in Otolaryngology and Head and Neck Surgery at Oregon Health and Science University. This training would lead him to a fellowship in Facial Plastic Surgery at the University of Michigan, an incredibly competitive program.

Beyond his expertise and training background, Dr. Weber is renowned for his passion for communication with his clients, always making sure that they feel comfortable every step of the way. Reach out to our office today to set up a private consultation.

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