Rhinoplasty has a long and varied history and is the first recorded cosmetic surgery procedure, with evidence suggesting it was performed as early as 1500 BCE. In 600 BCE, the Indian surgeon Sushruta provided detailed descriptions of his rhinoplasty technique.
Rhinoplasty technique continued to evolve over the years, with the closed approach employed during the 18th to early 20th centuries, until the 1960s when the open rhinoplasty technique was developed.
Rhinoplasty remains one of the most popular cosmetic surgeries in the UK and worldwide, with thousands of people opting for this transformative procedure each year. When considering rhinoplasty, the patient still must decide between the open or closed approach. Each method has unique advantages and considerations, making the choice crucial for prospective patients.
What is open rhinoplasty?
Open rhinoplasty is a surgical technique involving making an incision on the columella, the tissue strip separating the nostrils. This incision allows our Karidis Clinic surgeons to lift the skin covering the nose, providing direct access to the underlying nasal structures. The open approach is beneficial for complex cases, including significant shape and structural modifications.
What is closed rhinoplasty?
Closed rhinoplasty, or endonasal rhinoplasty, is a technique where all incisions are made inside the nostrils, leaving no visible external scarring. This approach is ideal for patients seeking minor to moderate changes in the appearance of their nose. During closed rhinoplasty, the surgeon accesses the nasal structures through these internal incisions, making it a more discreet option.
What are the differences between open and closed rhinoplasty?
- Incision location: The incision placement is the most apparent difference between the two techniques. Open rhinoplasty involves a small incision on the columella, whereas closed rhinoplasty utilises incisions hidden inside the nostrils.
- Visibility: Open rhinoplasty offers better visibility and direct access to the nasal structures, making it suitable for more complex cases. Closed rhinoplasty provides limited visibility, which is ideal for more superficial changes.
- Recovery time: Closed rhinoplasty typically results in a shorter and less painful recovery period due to its minimally invasive nature. Open rhinoplasty may involve more swelling and a slightly longer recovery.
- Scarring: While open rhinoplasty leaves a small external scar on the columella, closed rhinoplasty leaves no visible external scars.
- Surgeon preference: Some surgeons may prefer one technique over another, depending on their experience and the specific case’s requirements.
What are the benefits of having open rhinoplasty?
Open rhinoplasty offers several advantages:
- Precise surgery: The surgeon has a clear view of the nasal structures, allowing for precise modifications, making it suitable for complex cases.
- Versatility: It is adaptable and can address cosmetic and functional issues, such as breathing problems.
- Predictable results: The surgeon can better predict and control the final results, enhancing patient satisfaction.
What are the benefits of having closed rhinoplasty?
Closed rhinoplasty also has its own benefits:
- No visible scarring: With all incisions hidden inside the nostrils, no external scarring provides a more discreet result.
- Faster recovery: Patients usually experience less swelling and a quicker recovery than open rhinoplasty.
- Less invasive: Closed rhinoplasty is a less invasive procedure, which may reduce the risk of complications and discomfort.
How can you decide if open or closed rhinoplasty is best for you?
The decision between open and closed rhinoplasty depends on your individual goals, the complexity of the procedure, and your surgeon’s recommendation. Here are some factors to consider:
- Your goals: If you’re looking for significant changes to the shape and structure of your nose, open rhinoplasty may be the better option. Closed rhinoplasty is more suitable for minor to moderate alterations.
- Anatomical considerations: The current state of your nasal anatomy and any functional issues you might have should influence the choice. Open rhinoplasty is better for addressing functional concerns.
- Recovery time: Consider your available recovery time. Closed rhinoplasty typically has a shorter and less uncomfortable recovery period.
- Scarring concerns: If you’re worried about visible scarring, closed rhinoplasty is the way to go, as it leaves no external marks.
- Surgeon’s expertise: The experience and preferences of your chosen surgeon play a significant role. They will recommend the technique that best suits your case.
Another option is non-surgical rhinoplasty using dermal fillers. However, the most important factor in making the decision about whether to have an open or closed rhinoplasty is the advice you receive from your surgeon. Our surgeons Mr Alex Karidis and Mr Mark Ho-Asjoe will perform a thorough examination of the nose and advise you on the suitable procedure to achieve your goals.
At Karidis Clinic, our surgeons work closely with Mr Robert Quiney, an experienced ENT surgeon here at the Hospital of St John and St Elizabeth.
“During your rhinoplasty consultation, we will discuss both form and function,” Mr Alex Karidis explains. “If issues with nasal function are identified, and depending on the degree of the problem, then I recommend they see Mr Quiney for a consultation. If he thinks the functional issues can or should be dealt with surgically, then we will arrange an operation that will cover both aspects.
“We work at the same time; he joins me in the operation and addresses any internal issues that are affecting breathing and then I do the aesthetic side. The patient has best of both worlds.”