When preparing for plastic surgery, patients are asked the question: which is better - open or closed rhinoplasty? In fact, there is no right answer to this question. There is, of course, a fundamental difference between the two methods, but both are equally sought after. The choice of surgery method for a particular patient is determined individually and depends on many factors, such as:
- the nature of nasal defects. If a larger intervention is planned or if correction requires implant placement, sawing of the nasal bones, it is better to use open rhinoplasty, which means greater visualization of the operative field and visibility of even small structural elements.
- surgeon qualification. Closed access is not for every expert. The surgeon requires extensive experience in performing rhinoplasty, impeccable knowledge of anatomical internal structures.
- characteristics of the previous operation. Reoperation is usually performed using the open rhinoplasty technique, because it is extremely important for the doctor to see all the nuances of the previous intervention.
At the consultations in the office, the specialists take into account your wishes regarding the operation, but the final decision on whether to perform open or closed rhinoplasty is made by the doctor, based on the individual characteristics and indications of the patient.
Indications and contraindications for open rhinoplasty
Indications for open rhinoplasty
The indications for open rhinoplasty are the same as for any rhinoplasty:
- high, broad, flat posterior part of nose;
- asymmetry;
- falls and irregularities;
- rounded, lowered or too raised tip of nose.
Contraindications for open rhinoplasty
- age up to 18 years (the process of tissue formation is not yet complete);
- inflammatory ENT diseases;
- herpes in the active phase;
- decompensated diabetes mellitus;
- blood clotting disorder;
- menstruation.
Open rhinoplasty procedure
Open rhinoplasty is performed under general anesthesia. The patient must first pass the tests prescribed by the surgeon.
Open rhinoplasty provides a complete visualization of the operation process: the surgeon has the opportunity to examine all the structures of the nose in detail. During the correction, the surgeon makes an incision based on the columella (the area of skin between the nostrils). A small marginal incision is then made from the columella to the inside of each nostril.
With open rhinoplasty, the surgeon carefully cuts the skin in the area of the columella with special surgical scissors, separating it from the cartilaginous frame of the nose. Now the doctor has the opportunity to examine in detail all the anatomical components, assess the condition of the structures of cartilage and bone parts and give them the necessary shape. During open rhinoplasty, the doctor can remove and move parts of cartilage, bones, install special nasal implants, etc.
At the end of the open rhinoplasty, the surgeon applies a thin suture material to the incision area: delicate work with the incision allows you to get an inconspicuous scar. Turunds are installed in the nasal passages (removed the next day), a hard plaster bandage is applied (the doctor will remove it in 10-11 days).
Thus, the only and temporarily visible part of the incision in open rhinoplasty is the columella zone. The incision brightens and becomes invisible in a few months.
Rehabilitation after open rhinoplasty
You will be in the clinic for the first 1-2 days after the open rhinoplasty.
You can assess the primary result of open rhinoplasty after removing the cast, but the nose will still look swollen. The picture will be clearer in 1, 5 months from surgery. You must give up sports at least two months after open rhinoplasty. Contact sports (boxing, wrestling) can begin no later than 6 months: the nose after open rhinoplasty requires careful treatment and complete exclusion of even minimal injuries.
Two months after the open rhinoplasty, you should forget about the sauna, steam bath and wearing glasses.