Open or Closed Technique Nose Aesthetic Surgery!

What are the advantages and disadvantages of open technique and closed technique rhinoplasty?

Open and closed technique rhinoplasty

In the open technique, after the skin incision in the columella, the nose skin is dissected from front to back and the procedure is performed and a visible incision is seen. Complaints such as nasal edema, bleeding under the nose, numbness and pain can be expected more. However; open technique allows easy access and repair of all problem areas present in the nose. The open technique is more suitable, especially in patients with advanced cartilage curvature or nasal curvature. The experience and preferences of the surgeon and the patient's expectations are also important in the selection of the technique. Both techniques are safely applied in experienced hands.

Rhinoplasty is the most common aesthetic procedure performed today to improve the external appearance of the nose and to eliminate breathing difficulties. The operation performed in the surgery is basically the shaping of the bone and cartilage structure forming the skeleton of the nose. Although there is still no consensus about rhinoplasty surgery, many unknown and information polluting rumors continue.

Rhinoplasty techniques

Rhinoplasty can be performed by two techniques called open and closed. In open technique, the incision is made from the area called columella between the two holes of the nose to the skin. In closed technique, all incisions are made through the nose. There are no visible skin incisions. Those who prefer open technique claim that they are more dominant in the nose because they do every process. However, even if almost everything is done in the open technique, the integrity between the nasal skeleton and the skin covering it is impaired, and it is especially weak to evaluate the relationship between the nasal ridge and the tip during surgery.

Open technique rhinoplasty and incision scar

Open rhinoplasty, one of the nasal aesthetic surgery techniques, is started by making an inverse ’v’ ’incision from the outer part of the chamber between the nostrils (collumella). It is the surgical technique performed by removing the skin and subcutaneous tissues and interfering with the nasal bones and cartilages. Open rhinoplasty offers more intervention than closed technique. The internal structure of the nose, cartilage and soft tissue become more visible. Nasal tip aesthetics and revision rhinoplasty are particularly preferred. In open rhinoplasty there is the possibility of a scar on the tip of the nose due to the reverse ’V’ ’shaped incision. As these stitches heal, they become ambiguous.

Which technique is better?

There is controversy as to which technique works better. However, this debate continues on the wrong ground because there is no superiority between the two techniques. The choice here is more about the experience of the surgeon. Closed technique does not leave any visible marks, but requires a high level of experience and technical equipment; all kinds of surgical maneuver that can be performed with open technique can also be performed completely with closed technique in experienced hands.

In which situations is the open technique rhinoplasty technique preferred?

Open rhinoplasty may be preferred for the indications of aesthetic nose surgery such as severe nasal tip problems and severely distorted bone curvature. The most important advantage of open rhinoplasty is that it can be performed with direct vision. In open rhinoplasty, all the bone, cartilage structures and tissues in the nose are clearly visible. During open rhinoplasty, how much cartilage is removed from the tip of the nose, how much cartilage remains and their symmetry can be seen more clearly.

Which nose problems can be corrected with open technique rhinoplasty?

In open rhinoplasty from aesthetic nose surgeries, deformities, curvatures and missing or collapsed areas of cartilage can be detected and repaired. If there are broken areas, cartilage fragments can be added and shavings can be shaved. It provides a much more detailed analysis of the problem in the nose if functional and physical problems in the nose persist or occur even though the nose has undergone previous aesthetics. Nasal structural defects can be clearly identified and revision helps to plan nasal aesthetics more accurately.

Is there any difficulty in breathing after rhinoplasty operation?

Shortness of breath after rhinoplasty is a common problem that is often neglected but needs attention. Shortness of breath due to swelling in the early postoperative period is natural and transient, but if the swelling persists in the long term, there is a problem. Hidden, mild septal deviation that does not cause shortness of breath before surgery may cause shortness of breath in the patient if it is not noticed and corrected by the surgeon. Therefore, all patients with or without difficulty in breathing need to be carefully evaluated and necessary precautions should be taken during the operation of possible problems of septum deviation or turbinate hypertrophy. If these conditions are met, no breathing problem is encountered after rhinoplasty surgery.

What are the advantages of closed rhinoplasty?

The surgeon who will perform nasal aesthetic operation with closed technique should first of all have aesthetic and visual ability, sufficient experience and strong anatomical knowledge. Your doctor will first make a detailed analysis of your nose problems. It will then decide if it is appropriate and targeted technique for your nose problems. If surgery with closed technique is enough to solve the problems in your nose, your surgery can be planned accordingly. Especially in noses with cartilage deformities, it may be difficult to plan the operation with closed technique.

There are multiple reasons why nasal aesthetics is more preferred than closed technique. These:

• Minimal risk of infection,
• No scarring seen from outside,
• Less edema and bruising,
• It provides faster healing process.
• The healing process is much faster in closed rhinoplasty because there is no incision in the nasal skin and less damage to the intranasal soft tissue.

What is the importance of the technique used in nose technical aesthetics?

The technique used in nasal aesthetics is the surgeon's experience. Nowadays, there is no difference between open and closed techniques and procedures that can be performed in the nose. Both techniques can easily be used to eliminate possible problems in nasal esthetics. It is important in which technique your surgeon is more experienced. Open technique rhinoplasty is preferred when there is nasal deformities, past traumatic nasal deformations and altered anatomy due to operations.

What are the advantages of open rhinoplasty?

In some cases, such as severe nasal trauma, deformities, or revision operations, the closed technique may not be appropriate and your plastic surgeon may recommend an open rhinoplasty operation. This is because in the open technique, the nose structure can be seen more clearly. Especially in revision rhinoplasty, interventions to the nose can be seen more clearly in the first operation. Nasal procedures can be planned more accurately.

If you have chosen a specialist surgeon, he will tell you which technique would be more appropriate for you after the examination. In this case, following your surgeon's recommendations will ensure the successful completion of your surgery.

Both techniques have strong defenders. Each surgeon selects and applies a technique according to his knowledge, experience, experience, vision, goals, technique and philosophy. Since I prefer to use the underskin tissue of the nasal tip as the filling material to thetip, dorsum or root of the nose, I generally prefer open technique nasal aesthetic surgery.

Similar link >> Rhinoplasty in Istanbul

Source link >> Clinical Practice Guideline: Improving Nasal Form and ... - NCBI

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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