A rhinoplasty has the distinction of being one of a few surgical procedures that can correct both form and function. It is also unique in that rhinoplasty is a fully custom procedure that is different for each patient’s needs. Whether you are undergoing open rhinoplasty to boost your appearance or help your sinuses, or both, an open rhinoplasty may be the preferred method of your surgeon. An open rhinoplasty is also the preferred method if you are undergoing a second or third rhinoplasty as a corrective measure.
The Difference Between Closed and Open Rhinoplasty
The difference between an open and closed rhinoplasty procedure involves the placement of the incision. For an open rhinoplasty, the incision is placed across the columella. The columella is the tissue between the nostrils, on the underside of the nose. The skin is then lifted back for the procedure to take place. In a close procedure, the incision is placed inside the nose.
Depending on your unique rhinoplasty needs, as well as the desired outcome of the procedure, your cartilage and bone will be restructured and manipulated. Some people have more cartilage than others. Other people have more bone. Often people fear that their nose will be broken. While it is necessary to reset the bone for some desired results, this step may not be needed for people that have more cartilage. An open rhinoplasty is generally the preferred technique for working on the nasal tip. It also allows your surgeon to have maximum visibility and access to the nasal structure, without altering the existing structure of the nose.
Open Rhinoplasty Scarring
Many patients are concerned that an open procedure will result in too much scarring. The truth is that both procedures require scarring. For an open procedure, your skilled surgeon will find a location to make the incision the least noticeable when finished with the procedure. Using a careful closing technique minimizes the appearance of the scar and in most cases will not be visible.
The reason for minimal scarring is that your surgeon will use a V-Plasty incision. A V-Plasty incision minimizes the risk of your scar being seen. In fact, many patients will not even be able to see the scar themselves as this technique results in a nearly invisible scar.
There is often a misconception that rhinoplasty is only to make a nose smaller or narrower. Even in such cases, additional material is sometimes needed to create the desired result or solve the existing structural problem. Sometimes cartilage from the nose can be moved to build up the nose. In other cases, cartilage may be needed from elsewhere. Usually cartilage is found from the ear. This doesn’t create a visible scar because the incision is made behind the ear, where glasses go on those who wear glasses. Other times, the doctor may opt to use rib, although this can have more risks. For some patients, an FDA approved material may be used as an implant. The surgeon will explain the pros and cons and risks of all options based on your needs.
Before Your Open Rhinoplasty
Before you undergo open rhinoplasty, be sure that you understand the risks and consequences of your surgery. Your surgeon will provide you with a list of instructions to prepare for the procedure to help you have the best results. Although scarring is minimal to invisible with an open rhinoplasty, swelling and bruising can be considerable. You may even end up with a black eye or two.
It is also important that you have reasonable expectations for your open rhinoplasty. Your nose is the center of your face, but it is only one feature. The way your nose looks as a final result will likely vary slightly from the computer generated image that your doctor creates. And it will appear very different from any celebrity inspiration that you may have. Your nose is filled with unique muscles, tissues, cartilage and bones that can’t be replicated. Even if you want your bridge as straight as your favorite Hollywood star, it will appear very different on your face, surrounded by your features. Understanding the final outcome before your nose surgery can help you have better results.
After Your Open Rhinoplasty
After your rhinoplasty, you can expect to wear a nose splint for several days, and possibly over a week. During this time, you will also need to clean your nose according to your doctor’s instructions, usually by swabbing with hydrogen peroxide and antibiotic ointment. During this time, avoid the gym or vigorous activities that can disrupt the work that has been done.
You should also be prepared to wait a while for your final results. Once your splints and bandages come off, it will still take a while for your new nose to appear. Swelling and bruising takes a while to subside, anywhere from three weeks to three months. In addition, many patients don’t account for skin contracture. Skin contracture occurs when the skin on the nose settles back down after the procedure. This can take up nine months, and sometimes longer.
An open rhinoplasty procedure can give you the results you desire but the process is longer than just the time spent in the operating room. Preparing yourself before your surgery will facilitate your journey throughout the process and allow you to better enjoy your results.
