Breathing comes naturally to us. We take it for granted. Ever tried holding your breath for a few seconds? It puts a strain on the system does it not? Now imagine having breathing issues because of problems in the nose. These can be as small as snoring in the night or life-threatening like a too-narrow or blocked nasal airway leading to a decrease in the quality of life. It is critical that you seek an expert doctor’s opinion to make the necessary corrections in the nose to clear the smooth passageway. The good news is that a simple open rhinoplasty procedure for relieving breathing problems can fix nasal obstruction and greatly improve the quality of your life.
Open rhinoplasty is one of the oldest known nose surgery procedures. This history dates back thousands and thousands of years from the times of Sushruta and Charaka around 600 BCE when the first plastic surgery was done to reconstruct a nasal defect. Subsequently in the 16th-18th Centuries rhinoplasty saw many advancements when Gaspare Tagliacozzi developed techniques for nasal reconstruction, using skin grafts from the upper arm. In the 19th and 20th-centuryth centuries, rhinoplasty techniques and uses moved leaps and bounds ahead. Surgeons like Joseph Constantine Carpue in England and Johann Friedrich Dieffenbach in Germany performed nasal reconstructions using various techniques and advancements and the use of local anesthesia and improved surgical instruments allowed for more precise and controlled procedures. In the mid-20th century, surgeons began using the “open” rhinoplasty technique, which involves making incisions both inside the nose and across the columella (the tissue between the nostrils). This technique provided better visibility and access to the nasal structures during surgery. since that time the techniques of open rhinoplasty have moved towards a more individualized and refined approach, focusing on preserving or improving nasal function while achieving desired cosmetic outcomes.
Today open rhinoplasty employs various advances in technology, such as computer imaging and simulation software, which have allowed for better pre-operative planning and visualization of the potential results. Patient safety and aesthetic outcomes remain the prime importance for a surgeon in open rhinoplasty.
What can the open rhinoplasty do
Open rhinoplasty can correct almost all of the issues with the nose. These include crooked nose, a drooping or upturned tips, large nose, small nose, bump or dip in the bridge and breathing functions, nasal polyps, injury abnormalities, inflammations, symmetry balance, nostril correction etc. Breathing issues can cause a domino effect through the entire body. when you cannot breathe properly there is a lack of restricted oxygen in the body and the organs cannot function as well as they should. You might feel symptoms like breathing troubles, dizziness, light headedness, chronic headaches, and have trouble going about your usual daily jobs. Lack of proper oxygen supply in the body can make it troublesome to do physical activities and make it difficult to control your breathing or catch your breath after strenuous physical activities. Lack of air in the body or a difficulty in breathing can also cause loud snoring and Obstructed Sleep Apnea (OSA).
Troubles in the nose can also lead to other problem effecting your daily routine such as breathing through the mouth, insomnia, dry mouth, irritation in the nose and through, gum diseases such as gingivitis and bad breath. These issues can cab be problematic and fatal.
There are many issues that can cause the Obstructed nasal passage problem in breathing and warrant an open rhinoplasty
- Deviated septum what does not allow enough oxygen to pass through. A deviated septum occurs when the wall that separates the nasal passages (septum) is crooked or off-centre. This can obstruct airflow and lead to breathing difficulties. Rhinoplasty can correct the deviated septum by straightening it, thereby improving nasal airflow and alleviating breathing problems. It is one of the major reasons of obstructive sleep apnea.
- Enlarged turbinates: The turbinates are structures within the nasal passages that help humidify and filter the air we breathe. When the turbinates are enlarged, they can obstruct nasal airflow and cause breathing issues. they are responsible for keeping the nose moist and the air that does in at the regulated temperature. They usually swell in the night and they can cause cold, allergies and such.
- Structural abnormalities: irregularities in the nose, such as nasal polyps, nasal bone spurs, or excess tissue, can obstruct airflow and lead to breathing problems. Open Rhinoplasty can address these issues by removing or reshaping the problematic structures to restore proper nasal function.
- Nasal Valve Collapse: The nasal valve is a narrow area in the nasal passages that can become weak or collapse, resulting in restricted airflow. Rhinoplasty strengthens and provides supports to the nasal valve, allowing for improved breathing.
- Revision Rhinoplasty: If you have previously undergone a rhinoplasty procedure and are still experiencing breathing difficulties or unsatisfactory results, a revision rhinoplasty can be performed to correct any lingering issues and improve nasal function.
These problems can be caused because of a birth defect, or trauma to the nose. trauma to the nose needs to be looked into immediately as the injury can cause blood clotting which can further damage the cartilage and cause saddle nose and bridge collapse.
How is open rhinoplasty done?
In this type of nose surgery procedure, the plastic surgeons make incisions on the sides of the columella and across the columella of the nose to expose nose’s framework for better visibility inside the nose. This gives the surgeon more space and freedom to manoeuvre around and make more precise changes in the nose. Apart from the one incision across the nose, there is no visible scarring around the nose.
Open rhinoplasty is preferred in certain cases that require extensive modifications to the nasal structures or when increased visibility and access to the underlying nasal framework are necessary. Here are some situations where open rhinoplasty may be preferred:
- Complex Nasal Deformities: Open rhinoplasty allows the surgeon to have a direct and comprehensive view of the nasal structures, making it suitable for complex nasal deformities that require significant reshaping or reconstruction such as cleft lip.
- Revision Rhinoplasty: If a patient has previously undergone rhinoplasty and requires a secondary procedure to correct unsatisfactory results or address complications, open rhinoplasty is often chosen. It provides better visualization of scar tissue, grafts, and anatomical changes from the previous surgery.
- Nasal Tip Refinement: When precise modifications to the nasal tip are required, open rhinoplasty provides better access to sculpt and reshape the tip cartilages. This technique is commonly used to refine the shape, projection, or rotation of the nasal tip.
- Structural Abnormalities: Open rhinoplasty is suitable for correcting structural abnormalities, such as a deviated septum or nasal valve collapse. It allows the surgeon to assess and address these issues more effectively.
- Complex Cases Requiring Grafts: In cases where additional cartilage grafts or tissue augmentation are needed to provide structural support or enhance the nasal contour, open rhinoplasty allows for precise placement and fixation of grafts.
- Surgeon Preference: Some surgeons may prefer open rhinoplasty as their primary approach for all cases, as it provides them with a more comprehensive view and control during the procedure.
- Asymmetric nose: this procedure is done for cosmetic reason to improve the facial balance.
The advantages of open rhinoplasty
- It makes it more precises as the surgeon can see the actual anatomy under the skin. This makes it easier to measure and analyse the nasal structures which might have been missed with the external examination.
- Lesser changes of nasal asymmetry because of high levels of precision offered.
- More precise and accurate placing of grafts and prosthesis
- Less chances of septum or cartilage collapse and better stability of nasal elements.
- More success in complicated surgeries
- Less chances of revision surgery, scaring, bruising and swelling.
Open rhinoplasty, can have a positive impact on a person’s quality of life in several ways. Here are some ways in which the quality of life may improve following open rhinoplasty:
Improved Breathing: Enhanced breathing can lead to better sleep, increased energy levels, and overall improved physical well-being.
Enhanced Facial Harmony: By reshaping and refining the nose, the overall facial appearance can be improved, leading to increased self-confidence and satisfaction with one’s appearance.
Corrected Nasal Deformities: The surgery can achieve a more aesthetically pleasing and harmonious nasal appearance, which can positively impact a person’s self-esteem and self-image.
Reduced Psychological Distress: Individuals who have been self-conscious or unhappy with the appearance of their nose may experience psychological distress or a negative body image. Open rhinoplasty can help address these concerns, leading to improved self-confidence, self-esteem, and overall psychological well-being.
Improved Social Interactions: Open rhinoplasty can reduce self-consciousness about the nose, allowing individuals to feel more comfortable in social settings and engage more confidently with others.
Easier Makeup Application: Following open rhinoplasty, the improved nasal contours enhance a person’s daily grooming routine and contribute to an improved sense of self-care and confidence.
Open rhinoplasty is done under general anaesthesia and takes about 2-3 hours to complete. The recovery takes about 10-14 days.