What is an Open Rhinoplasty?

An open rhinoplasty is a cosmetic surgery procedure that is performed to widen, narrow, shorten, or elongate the nose. The procedure involves making an incision across the tissue separating the nostrils called the columella and several smaller cuts inside the nose. Open rhinoplasty is usually an elective surgery that patients undergo to improve their appearances, but the procedure may be necessary in some cases to relieve airway obstructions or correct congenital defects. Another similar surgery called closed rhinoplasty is sometimes preferred to shorten healing time and avoid visible surgical scars.

When a person needs or wants an open rhinoplasty, he or she first needs to undergo a thorough medical evaluation. A doctor reviews the patient's medical history, current medication use, and allergies to make sure he or she will be a good candidate for anesthesia and surgery. A physical exam allows the doctor to study potential problem areas in the nose, such as a soft tissue obstruction or a deviated septum. In addition, x-rays and other diagnostic imaging scans of the nose and jaw are usually performed to check for underlying bone abnormalities.

A plastic surgeon can choose to perform either closed or open rhinoplasty after carefully considering the advantages and drawbacks of each. In general, closed procedures are preferred when the nose only needs to be slightly modified or the problem area can be operated on through a nostril. Open rhinoplasty is helpful on major reconstructive projects where a large area of tissue or multiple spots in the nose need to be corrected. By making an external incision in an open procedure, a surgeon has easier access to internal structures. It usually takes longer for patients to recover from open surgery and they may have columellar scars that never fully heal.

Before open rhinoplasty, a patient usually receives a general anesthetic. Once the patient is sedated, the surgeon makes a cut in the columella to expose the internal nasal cavities. He or she can then use scalpels, saws, tweezers, and other precision instruments to remove cartilage and realign bones. Once the procedure is completed, the surgeon uses stitches or glues to suture internal openings and the columellar incision. The entire procedure usually takes less than two hours, and the patient can usually go home on the same day of his or her surgery.

In the first few days after open rhinoplasty, a patient can expect to have pain, swelling, and breathing difficulties. He or she is usually prescribed painkillers, antibiotics, and a saline spray to help relieve discomfort. In addition, a surgeon may decide to fit the patient with a soft plastic splint to wear for about one week to help support and protect the tender nose. Follow-up visits in the weeks and months after surgery are important to make sure the procedure was successful and that the patient is recovering on schedule.