Open Rhinoplasty vs. Closed
Albany's Dr. Edwin Williams Highlights the Differences Between Two Techniques
When it comes to nasal surgery, no matter the specific nasal deformity being addressed, there are two main techniques to consider: open rhinoplasty vs. closed. Albany, New York's Dr. Edwin Williams almost exclusively performs closed rhinoplasty, but has extensive experience in both procedures.
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In fact, Dr. Williams consistently used the open rhinoplasty approach throughout the first decade of his career performing nasal surgery. Since this technique allowed him visual access to the internal structures of the nose, it was an effective way for him to study and become incredibly familiar with its anatomy. His 10 years of consistent, hands-on work via open rhinoplasty ultimately equipped him with the skills and knowhow to confidently and regularly perform the closed technique. While the closed or endonasal technique can be technically demanding, once a surgeon has a tremendous amount of experience, all of the surgical maneuvers—and resulting outcome—can be accomplished through this approach. The experience facilitates a clear, three-dimensional understanding of the anatomy, necessary for surgery without opening the nose and exposing all of the underlying tissue, which also leads to associated recovery and external incision and scarring.
The Open Rhinoplasty Technique
To perform an open rhinoplasty, the surgeon makes an incision on what is known as the columella, which is the thin line of skin and soft tissue between the two nostrils. The incision may not run in a straight line so as to better camouflage any scar.
From here, the surgeon lifts away the nasal skin, pulling it up to physically see the cartilage and more. The visually oriented nature of open rhinoplasty makes it ideal for doctors who prefer direct visualization.
Once the necessary alterations are complete, the nasal skin is re-draped and sutured into place. Great care is taken to minimize the appearance of resulting lines.
Benefits of the open rhinoplasty technique include the precision such direct access allows—though this can be learned over time and applied even in the closed technique.
The Closed Rhinoplasty Technique
As the name implies, closed nasal surgery happens entirely inside the nose, with no opening or lifting away of the skin above. Because there is no direct line of sight, the surgery itself must be performed with great technical skill.
Since there are no external incisions made, there are no external sutures or related scarring to consider. Other benefits related to this include a shorter recovery time marked by less swelling than occurs with the open rhinoplasty approach, since there is no external healing necessary.
Which is Better: Open or Closed Rhinoplasty?
Though Dr. Williams prefers the closed approach at this stage in his career, the question of whether open or closed is better actually depends on the patient and the details of the surgery itself. In some cases, an open rhinoplasty approach might be considered most appropriate. Since every case is unique, the issue of open vs. closed rhinoplasty will be determined at an initial consultation. Dr. Williams will explain the reasoning behind his recommendation and work with each patient to develop a plan best suited to delivering the desired results.
Factors that may be weighed include the nasal deformity being addressed, whether this is a primary or secondary (revision) surgery, patient preference, and more.
Dr. Williams performs surgeries to address a nasal hump, overly large nose, saddle nose deformity, crooked nose, crooked tip or nasal base, pinched tip, or drooping nose. With every surgery, he takes a variety of elements into account, include whether the patient is male or female, the age of the patient (adult or teenager), and the patient's ethnicity. All of these variables will help him determine the approach to take.
Your Surgeon Matters
No matter the technique used—open or closed rhinoplasty—it is important to choose the right surgeon for you. There is considerable value in selecting a specialist, especially since the nose is such a prominent part of the face and draws such significant attention. It is also important to seek out a surgeon who not only focuses on the nose, but who has considerable experience in performing actual surgery on the nose. This is especially true in the closed technique, but no matter the preferred approach, the more nasal procedures a surgeon has performed, the more cases that surgeon will be able to draw on when handling the next surgery.
Be sure to ask about a surgeon's experience with both open and closed rhinoplasty procedures during the consultation, as well as any other questions necessary for you to feel comfortable and secure in your choice.
If you're considering nose surgery and want to consult with an experienced and modern Albany-area facial plastic surgeon well-versed in both open and closed rhinoplasty techniques, contact Dr. Edwin Williams at the Williams Center by calling 1-800-742-2797 or sending a message online today