When preparing for plastic surgery, patients ask themselves: which is better - open or closed rhinoplasty? In fact, there is no exact 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 given patient is determined individually and depends on many factors, such as:
- nature of nasal defects. If a large amount of intervention is planned, or if the correction requires the installation of implants, sawing of the nose bones, it is better to use open rhinoplasty, which involves greater visualization of the surgical field and visibility of even small structures and elements.
- surgeon qualification. Closed access is not for all experts. The surgeon requires extensive experience in performing rhinoplasty, impeccable knowledge of internal anatomical structures.
- characteristics of the previous operation. The reoperation is usually performed using the open rhinoplasty technique, as it is extremely important for the physician to see all the nuances of the previous intervention.
During the consultation at the clinic, specialists take into account your wishes regarding the operation, however, the final decision to perform open or closed rhinoplasty rests with the doctor, based on the patient's individual characteristics and indications.
Indications and contraindications of open rhinoplasty
Indications for open rhinoplasty
The indications for open rhinoplasty are the same as for any rhinoplasty:
- bridge of the nose high, broad and flat;
- asymmetry;
- dips and irregularities;
- nose tip rounded, lowered or too high.
Contraindications of open rhinoplasty
- age up to 18 years (the process of tissue formation has not yet ended);
- otorhinolaryngological inflammatory diseases;
- herpes in the active phase;
- decompensated diabetes mellitus;
- blood clotting disorder;
- menstruation.
Open rhinoplasty procedure
Open rhinoplasty is performed under general anesthesia. Previously, the patient must undergo the examinations prescribed by the surgeon.
Open rhinoplasty provides a complete view of the operating process: the surgeon has the opportunity to examine in detail all the structures of the nose. During the correction, the surgeon makes an incision at the base of the columella (the area of skin between the nostrils). Then, a small marginal incision is made from the columella to the inside of each nostril.
In open rhinoplasty, the surgeon carefully cuts the skin in the columella region with special surgical scissors, separating it from the cartilaginous structure of the nose. Now the doctor has the opportunity to examine in detail all the anatomical components, assess the state of the structures of the cartilaginous and bony sections and give them the necessary shape. During an open rhinoplasty operation, the doctor may remove and move pieces of cartilage, bone, install special nasal implants, etc.
At the end of the open rhinoplasty, the surgeon applies a thin suture material in the area of the incision: the delicate work with the incision allows to obtain an imperceptible scar. Turundas are installed in the nasal passages (they are removed the next day), a hard plaster bandage is applied (the doctor will remove it for 10-11 days).
Thus, the only and temporarily visible part of the incision in open rhinoplasty is the columella area. The incision clears and in a few months becomes invisible.
Rehabilitation after open rhinoplasty
For the first 1-2 days after your open rhinoplasty, you will be in the clinic's hospital.
You can assess the primary outcome of open rhinoplasty after the cast is removed, but the nose will still look swollen. The image will become clearer at 1. 5 months after surgery. At least two months after open rhinoplasty, you must give up sports. Contact sports (boxing, wrestling) cannot be started before 6 months: the nose after open rhinoplasty requires careful treatment and the complete exclusion of minor injuries.
For a period of two months after open rhinoplasty, you should forget about sauna, steam bath and wearing glasses.