Rhinoplasty is an intricate surgical procedure. It is done essentially done to improve the form and function of the existing nasal anatomy. The skin, the underlying cartilage, bones, tissues and lining all can be altered to suit the patient’s need. Rhinoplasty is classified in two types depending on the type of the incision that is made by the surgeon: open rhinoplasty and closed rhinoplasty.
Open Rhinoplasty is one of the oldest surgery procedures for nose jobs. The history of open surgery procedure for Rhinoplasty dates back to the year 1921 by Rethi who first used open Rhinoplasty for nasal tip modification. Over the years open Rhinoplasty had its own ups and downs till the year 1970 when surgeons started advocating the open approach for surgery for the nose.
Rhinoplasty can be done for various reasons such as internal and external anatomy changes, change in aesthetic appearance, botched up previous rhinoplasty procedures, functional problems such as obstruction in airways, collapsed septum etc., and nasal anomalies rising from genetic heritage and ethnicity. Open Rhinoplasty can be used to correct various problems such as:
- Cleft lip
- Fractures in the nose
- Burn injuries
- Infections such as syphilis causing discomfort
- Alter ethnic and genetic characteristics of the nose
- Restoring the balance of the face
When considering a patient for open Rhinoplasty the surgeon will look at various things. These include
History of the Patient
The first consideration for Rhinoplasty is the history of the patient. Apart from the medical history the surgeon will also enquire about the lifestyle of the patient and various aesthetic problems that they feel that they face. Also come under considerations the past symptoms, medications, allergies any kind of substance use etc. Not only this, the patient’s physiological profile is also kept in mind.
Present Physical condition and nasal Anatomy
The surgeon will give the patient a complete physical examination. Facial and nasal analysis forms an important part of the same. The type of the skin, symmetry of the skin, balance of the facial feature etc. are noted and documented. A detailed physical examination of the internals and externals of the nose is done in order to evaluate the scope of open Rhinoplasty. Routine tests for anaesthesia will be done.
Open Rhinoplasty is very suitable for:
- Correcting the nose tip
- Patient’s with thick nasal skin
- Non Caucasian patients
- Requirement of shield grafts
- Patients coming in for revision Rhinoplasty
- Patient’s with thick nasal skin
- Removal of tumour in the nose
- Septum reforms
Advantages of Open Rhinoplasty
There are many advantages of Open Rhinoplasty. It is a complex procedure and the benefits include:
- It gives the surgeon a direct exposure to the underlying cartilages, bones and tissues. This makes it easy to inspect and look for any other problems that might be present and can be worked on. Also the surgeon will be able to better asses the framework of the nose.
- A precision is handed to the surgeon when performing open Rhinoplasty. The modifications and abnormalities can be handled with precision for example the tip modification, grafts placement, osteotomies (forceful fracture of the bones to alter the shape and size of the nose)
- For new surgeons open Rhinoplasty gives them a good learning platform. For experienced surgeons it becomes a great training platform.
However Open Rhinoplasty has its own downsides too. These include
- Increased scarring is one of the most common disadvantages of open Rhinoplasty. However this is not a permanent problem.
- Open rhinoplasty takes a longer time compared to the other option
- Post-operative problems in circulation of blood in the nose and numbness
- Loss of blood supply to the nose can also cause necrosis in the columellar flap cause discomfort to the patient.
Open Rhinoplasty is strongly recommended for patients who need large amounts of work on their nose for example if the nose is too long and protruding from the face or if it is too short i.e. too close to the face. Expert surgeons will be your best choice for open Rhinoplasty.