Open and closed rhinoplasty techniques

Rhinoplasty , or nose job surgery, is a plastic surgery procedure used to change the shape of the nose.There are two main rhinoplasty techniques – open and closed. Both of these techniques are widely used by qualified plastic surgeons. In addition, both rhinoplasty techniques certain advantages and disadvantages, that have always been a reason of discussion for many cosmetic surgeons.

During the closed rhinoplasty procedure, a surgeon makes several incisions inside the nostrils, without getting outside the nose. Using the open rhinoplasty technique, a surgeon makes an additional incision on the columella (an area outside the nose between the nostrils) and certain incisions inside the nose, just like during the closed technique. Then, a plastic surgeon lifts the nasal skin carefully back in order to be able to work on the cartilage and other tissues inside the nose. Open rhinoplasty is used mainly in more complicated cases.

Open and closed rhinoplasty advantages

The main advantage of the closed rhinoplasty technique is no visible scarring after surgery. Since incisions are made inside the nose, they are totally invisible after nose job.

As an additional incision on the columella is made during the open nose surgery procedure, it leaves with a noticeable scar. This scarring is not very visible, and decreases with time but still, open rhinoplasty is not totally without scars

The main advantage of the open rhinoplasty technique is that it offers a surgeon to see the inner cartilage network properly and work on the inner structures more precisely and freely. Therefore open nose job surgery is chosen in more complicated cases, when more work needs to done by a doctor in order to achieve a desired result. This is especially favored by surgeons, who need to perform ethnic rhinoplasty surgery.

Since closed nose job surgery is used in order to improve minor defects of the nose, it lasts shorter than the open technique. Usually, closed rhinoplasty may take from one to two hours, whereas open rhinoplasty may last up to four hours.

Many surgeons prefer closed nose job surgery because it allows a shorter recovery period afterwards. Also, swelling and bruising is smaller and lasts shorter when the closed rhinoplasty technique is used.

Open and closed rhinoplasty disadvantages

The only disadvantage of the closed rhinoplasty technique is that it has limited use, and it cannot be applied to everyone. The best candidates for this procedure are those in need for minor modifications in the appearance of the nose. During closed nose surgery a small hump can be corrected but all other characteristics of the nose should be close to perfect. A patient should have a symmetrical shape of the tip of the nose. In addition his/her nose should be not too long and not crooked. The patient should not require a complicated surgical procedure for improvement of other nose features.

The open rhinoplasty technique has a few more disadvantages as compared to the closed one. It may leave the patient with the scar on the columella. There is also a greater risk for necrosis of the operated columella. In addition, the patient may experience extensive swelling, bruising, and numbness of the treated area.

If you want to have nose job surgery in order to improve your facial appearance or solve breathing problems, you should consult a qualified plastic surgeon. After discussing your problem and desired results of this cosmetic procedure , your doctor and you can decide which technique is most suitable in your case. Even though both techniques have certain advantages and disadvantages, they are both used widely in specific cases. Of course, a closed rhinoplasty technique requires a lot more skills but every qualified plastic surgeon can perform it. You only need to find one, who has the greatest experience in nose jobs.

Alternatives to rhinoplasty

Are there any alternatives to rhinoplasty? – is a frequent question amongst those who want to fix their nose, but do not want to choose rhinoplasty. For other purposes such as breathing problems there are some alternatives, but not many.

For instance if there is a problem with breathing through the nose doctors can help by offering the steam-heat procedures or procedures that contains cream therapy. If patient wants to change the appearance of the nose the rhinoplasty is necessary – even face massage is helpless in this case. The other way would be to work on other aspects of the face to improve proportion. It can be helpful; imagine a patient with a large nose and a small chin; by treating the chin the balance and harmony to the facial features can be reached. However, the changes of the chin would be significant! On the other hand it would be a huge mistake to try to take a large nose and make it very small to match a very small chin. Also soft tissue fillers can sometimes conceal nasal defects, but only the small ones. If person has a small chin, a chin implant can be used to balance a large appearing nose. The make up can be used too. It hides the imperfection – pro tempore. There are no other possibilities. So if you decided to change the shape of your nose, there is the only way to do it – to choose rhinoplasty.

Ethnic rhinoplasty

Individuals of different races differ from one another in certain anatomical features. There are specific anatomical differences between the noses of nonwhites and those of whites. Even though, sometimes people want to gain features that are distinctive for another race, most usually individuals undergoing plastic surgery wish to improve their appearance by keeping their ethnical features. And hence, plastic surgeons should be aware of these racial differences and should use specific surgical techniques to gain desired aesthetic results.

The idea of multiracial rhinoplasty evolved in 1913 when Schultz published his work characterizing typical black nose. Many authors have pointed out that noses of non-whites are broad, flattened, with thick nasal skin and huge amount of subcutaneous tissue. However, these stereotypic characteristics differ in individuals. Even though individuals are of the same race, their noses may differ dramatically.

Ethnic rhinoplasty

Patients, who seek ethnic rhinoplasty procedure, usually want to improve their appearance by keeping their racial heritage characteristics. Candidates for this type of plastic surgery are those, who have characteristics of the nose typical for their race. People, who have noses with widened bases, thicker skin, flat bridge etc., may want to improve aforementioned features and gain more prominent nose by keeping in their ethnic group.

Differences in nasal anatomy

African American nasal anatomy differs from others in skin thickness and abundant fibrofatty tissue. Nasal bridge consists of short bones, and is flat and wide. The tip of the nose is usually bulbous and of minimal definitions. The nostrils are flaring and horizontal. These are the features that individuals of African American decent want to correct but not change completely in order to keep their racial characteristics.

Hispanic nose also has a thick skin with a wide bridge. Its tip is also bulbous, of minimal definition with abundant nasal soft tissue. The base of the Hispanic nose is wide, thick, with flaring and horizontal nostrils.

Asian nasal anatomy differs a bit more from the African American and Hispanic nasal anatomy. Skin of the Asian nose is thick and sebaceous, and also heavy. Its bridge is wide. The tip of the nose is bulbous, with thickened skin, abundant nasal soft tissue and of minimal definition. But both the doctor and the patient should understand the presence of individual varieties.

Best candidates for ethnic rhinoplasty

Who are the best candidates for ethnic rhinoplasty? Basically these are multiracial individuals, who want to improve their nasal appearance and preserve defining racial features. These patients should be in a good general condition, have no major physical or mental disorders which would limit the possibility of plastic surgery. Also, this individual should have realistic expectations for this procedure.

The incidence of ethnic rhinoplasty has increased during the recent years. Imptoved new surgical techniques and excellent technology as well as good advertising campaign made ethnic rhinoplasty procedure more favorable to multiracial patients. Since populations of multiracial immigrants are growing, the amount of multiracial individuals requesting for ethnic plastic surgery is increasing, especially in large centers of urbanization. In some places the doctor might have only nonwhite patients. Some surgeons only practice in ethnic plastic facial surgery.

Ethnic rhinoplasty surgery

The aims of ethnic rhinoplasty may vary from individual to individual, but there are some major points that in ethnic rhinoplasty. The surgeon aims to make the nasal bridge slightly thinner. Most of the multiracial patients wish to see their tip of the nose more refined, increased in rotation and projection. Since skin soft tissue is abundant in most non-white individuals, most doctors try to give the soft tissue slight thickness in order to provide excellent definition of the tip of the nose.

Ethnic rhinoplasty involves a few different surgical procedures to improve appearance or function. Septoplasty with or without Graft Harvesting is most usually used in patients with a curved nasal septum. Incisions and skeletonization is needed for primarily open technique. Nasal tip surgery is applied to achieve better appearance of the nasal tip. Other procedures include the following: osteotomies, harvest/placement of autologous and/or alloplastic grafts, and alar base reduction.

It is quite complicated to describe individuals, who request ethnic rhinoplasty . It is just as hard as to describe white people, who want to have facial plastic procedures. Younger multiracial individuals usually want to undergo facial plastic surgery to improve their appearance and to keep their ethnic characteristics. Older patients want to reverse effects by aging on their noses. However, there is a great deal of individual, who want to have their nasal function restored. But no matter for what reason, aesthetic or functional, ethnic rhinoplasty is quite a frequent plastic surgery among multiracial individuals.

Rhinoplasty results

Most rhinoplasty patients can go back to their normal life approximately within the month after the operation. Need weeks to see rhinoplasty results which are really noticeable.

Rhinoplasty results

Within the weeks nose will look natural. Patients should be aware that the healing time is a long process that can take up a year to see the end results. But when the whole process will be done the patient will be proud of his/herself.

 

All the conren about how he/she looked like before, how ugly he/she has felt all the time will disappear and the self-confidence will return, the happines of having the new beatiful face will enrich people’s life. More to say, when people see the results of rhinoplasty, they even forget how much money rhinoplasty cost !

Best candidates for rhinoplasty

It doesn’t depend on sex. Men and woman can be candidates for rhinoplasty. Exception is done only for girls under 15 and boys under 17. In such cases most surgeons will caution againts the procedure.

The patient is an ideal candiate for rhinoplasty if: his/her nose is large for a face, nose is off-centre or crooked, the nasal tip droops or plunges, previous injury has made nose asymmetrical, nose seems too wide, nostrils are exaggerated flared, there is a bump on the nasal bridg. It is very important for patient to have the idea how he/she would like to look after the rhinoplasty procedure. In such cases most surgeons will caution againts the procedure. When the rhinoplasty procedure is over bruising and swelling appears around the nose and eyes, it is normal. The recovery lasts about for 2-3 weeks.

How should I prepare for rhinoplasty?

If the patient is a smoker he/she will be asked to stop smoking. Some medications, such as aspirin, must be avoided, because it can cause increased bleeding. The surgeon will provide the patient with additional preoperative instructions. If the procedure will be provided on outpatient basis ask someone of your friends or relatives to drive you home and to stay for at least one night

Rhinoplasty risk and complications

What temporary side effects can appear? – a dull headache, numbness or an aching nose of certain areas on the nose. Healing may last longer if bones were broken. Most people after the rhinoplasty return to work approximately after two weeks. Time is needed for the bruising and swelling to disappear.

Rhinoplasty risks

It’s usually recommended that activities which could result an injury should be avoided for six weeks. Be patient – clear rhinoplasty results can be seen a week after surgery or even later. So don’t start to regret for your choise to do the rhinoplasty operation if the results don’t unjustify your expectations. It is long period of healing – the final results will be seen after the 4-6 months. After the several weeks surgeon will give you recommendations for resuming your normal activities. These suggestions include: avoid sport activities (swimming, playing sport games) also those activities that increases your blood pressure ( for eg. Sexual relations) for more than two weeks. DON’T rub the nose or getting it sunburned (eight weeks). Be careful while washing the face and hair also be gentle using cosmetics. If you have poor eyesight you can wear contact lenses, but glasses are another case. It’s not good to wear glasses when the splint is off. It is possible only then your nose will completely heal. Your surgeon will give you frequent visits during several months after nose surgery. It’s necessary for checking on the progress of your healing. If you have any unusual symptoms or any questions, don’t be afraid to call your doctor for the consultation.

Rhinoplasty complications

There can be some complications also, for instance: abnormal shape of the nose (it can be a mistake made during the rhinoplasty surgery or if the patient doesn’t keep head elevated enough or sleeping on one side only, it can be corrected by secondary surgery, often the implant is used), anesthesia reaction, asymmetry, bleeding (it can occur for up to four weeks – the nasal packing may be used to contril it), infection (pain, redness, swelling), loss of smell, sinusitis, slow healing, toxic shock syndrome, wound infection (using an implant increase the chance of infection) , visible scar, risk of smoking (if the patient smokes, he/she can have difficulties during the healing process. Patient may feel the lack of oxygen needed to tissues and this increases the risk for slow healing). If surgery is performed by really qualified plastic surgeon it’s rare case for complication to appear after the rhinoplasty procedure. On the other hand all surgeries have therisk of complications. The part of healing process also depends on the patient. He or she must follow all the instructions which were given.

Rhinoplasty surgery

Rhinoplasty otherwise called nose surgery is one of the most popular plastic surgery procedures. It’s a medical procedure that reshapes the nose for cosmetic or reconstructive purposes. During the rhinoplasty procedure it’s possible to reduce the size of the nose, to straighten it or to change the angle between the nore and upper lip. Also to correct an injury or birth defect or to improve breathing problems.

Rhinoplasty techniques

One of two techniques can be used during rhinoplasty surgery . The first one is open technique and the second one – closed technique. Both techniques leave incisions made inside the nostrils. If the open technique is used most of the incisions remain inside the nose. One incision made across the Columella. It is the cartilage that separates the nostrils. The cartigale is lifted over the nose to allow the cartilage structure of the nose to be seen. It can be seen in its natural state and then the surgeon can make surgical changes to create more aesthetically pleasing nose. There is one disadvantage – after the procedure with open technique patient will have a small permanent scar across the columella. As the matter of fact this scar is so small that it can’t be seen even in sight. When the closed technique is used the incisions are made inside the nose. Then cartilage is pulled out from the nose and shaped.

 

Be careful – trust this procedures only for an experienced surgeon. Unlike the open technique the closed one doesn’t leave visible scars. The procedure with closed technique takes less time than the procedure with open technique. Also if the patient wants to reshape or give prominence to the appearance of the nose surgeons may offer nasal implants which come in a variety of shapes and sizes.

Rhinoplasty cost

Information about the cost of rhinoplasty will be given to the patient after the consulation. Plastic surgeon must complete a in-depth test for developement of patient’s individualized surgical plan and only then fees will be discussed with a patient.

Rhinoplasty cost

The most important decision is to choose a qualified surgeon. There are many important considerations which must be taken into account when making your choice. Rhinoplasty is really safe cosmetic procedure, but the choosing a doctor to perform that surgery must be taken in serious consediration. Rhinoplasty has become a very common procedure during the past several years and more accepted in our society. Also the number of illegal procedures is on the rise. Patients hoping to save money consult with these illegal ‘surgeons’, please don’t be naive and remember the choice of a rhinoplasty surgeon is the most important. Nowadays there a lot of doctors whose treat themselves as specialists though they are not. They have only a minimal training necessary to perfom the procedure. Keep this in mind before making a choise and select a good doctor who is professional in this field. There always is a  risk in this procedure like in any other surgical procedures. But qualified rhinoplasty surgeons will know what to do in case if the potential risk will arise. That surgeons have been trained to immediately recognize and react to any unexpected complications.

Here you can see list of the approximate prices:

 Procedure  Cost
 Primary open rhinoplasty $3.150- $6.500
 Primary closed rhinoplasty $2,879 – $5,800 
 Primary Septoplasty/Turbinectomy $3,500 – $6,500 
 Secondary open rhinoplasty $7,000 – $9,000 
 Secondary closed rhinoplasty $2,643 – $10,000

 Cost range $3.000-$12.000 
 Average total cost $4.500
 Surgeons fee $3.000
 Anesthesiologist $700 
 Facility fee $800

*Fees generally vary according to region of country and patient needs.