Rhinoplasty: New York... Modern Treatment
Modern rhinoplasty is performed using one of two broad categories of surgery. Traditional, closed ("endonasal") rhinoplasty employs incisions that are hidden within the nostrils. External, or "open" rhinoplasty involves connecting the intranasal incisions with a small external incision in the columella, (the fleshy, midline pillar that separates the nostrils.
The great advantage of endonasal rhinoplasty is the avoidance of exposed facial scar. Many primary rhinoplasties can be successfully performed using this technique. However, certain factors may move the surgeon to choose an open approach, including:
- Difficult nasal tip modification needed
- Internal nasal valve dysfunction
- Thick nasal skin
- Repair of septal perforations
- Belonging to a racial group other than white
- Posttraumatic nasal deformity with a deviated septum or dorsum
- Need for Major augmentation with tip with grafts
- Revisional rhinoplasty
The advantages of open technique in these instances are its provision of direct exposure, inspection, and assessment of the osteocartilaginous framework and facilitation of precise modification and stabilization of the abnormality (tip and dorsum modifications and graft placements). The main disadvantages include the small, external scar, longer surgery, and more persistent post-operative swelling and numbness.
| Examples of closed and open technique are accessible via the menu below. Changes from preoperative to postoperative appearance are illustrated using computer-generated "morphs" of the actual photographs. |