Open Rhinoplasty

Open Rhinoplasty involves performing cuts internally, externally, and near the nasal bridge, and is not subjected to the same limitations of Close Rhinoplasty. It is recommended for individuals with less nose tissue who wish to have a prominent nasal bridge and tip shape, nose humps that are too large to be filed down, short or deviated noses, bulbous nasal tip, uneven nostrils, crooked noses, or those who have previously undergone Closed Rhinoplasty with complications.

This approach will typically involve performing cuts around the nose area for correction, and making adjustments to the nose structure (bone, cartilage, and skin). These may be taken from elsewhere in the body, including conchal cartilage, septal cartilage, and/or rib cartilage. The doctor will typically apply general anesthesia. Details of the surgery will depend on the nature of the complications. Let me explain the most common cases:

• Removing large nose hump: With the open rhinoplasty approach, the doctor can apply force and remove the hump, which is more effective than having to file it down in the close rhinoplasty approach.

• Short or deviated nose and bulbous nasal tip: The recommended approach is to remodel the cartilage structure to achieve a more desirable shape. This is also effective for bulbous nasal tip correction.

• Uneven nostril & crooked nose: Again, the recommended approach is to remodel the cartilage structure in conjunction to performing nose osteotomy, to achieve the desirable shape.

• Flat-looking nose caused by extra-wide nasal bridge: General rhinoplasty may result in an uncommonly large nose. Open rhinoplasty offers the benefit of nose osteotomy to help reshape the nasal bridge to the more desirable shape.

• Bulbous nasal tip: If the problem is caused by thick nasal tip tissue or wide nasal tip cartilage, then it is recommended to perform Open Rhinoplasty to remove some of the excess internal nasal tip tissue -- this will result in a slimmer-looking nasal tip. To mitigate wide nasal tip cartilage, it is recommended to trim the cartilage in parallel with restructuring the nasal tip cartilage. If the bulbous nasal tip is coupled with a prominent alar, it is recommended to undergo alar resection as well. Alar resection can be performed together with or separately from closed or open rhinoplasty.

• Uneven nostrils: This can be mitigated by restructuring the nasal tip or nostril cartilage.

• Complications from past Closed Rhinoplasty operations: The doctor will typically remove the silicone to reduce the risk of implant protrusion or infection. To maintain the same look without having to remove the silicone, the recommended option is performing Open Rhinoplasty and reusing cartilage from other parts of the body. This is effective for thin nasal tips that risk implant protrusion.

All of the above complications can often be corrected by Open Rhinoplasty. For individuals with prominent nasal bridges who also want to enhance the nasal tips, the Close Rhinoplasty approach will require applying the implant from the bridge to the tip -- this may lead to an unnatural nasal bridge shape. On the other hand, Open Rhinoplasty provides the option to take pieces of cartilage from other body parts and only apply the implant to just the nasal tip, resulting in a more natural shape. For those with nose fillers and are experiencing capsular contracture, Open Rhinoplasty is required to remove the capsular contracture prior to performing the operation.

Despite providing several benefits over Close Rhinoplasty, this approach is more complicated and consumes more resources, therefore it is more time-consuming and may command higher fees. As the operation will modify the nose structure, an Open Rhinoplasty patient will be forced to select the approach again as the only option for future nose surgery attempts.