Various techniques are possible for changes to the external nose. Basically, a distinction is made between closed and open rhinoplasty. In closed rhinoplasty, the surgical accesses are placed completely inside the nose. With this minimally invasive procedure, it is not visible from the outside that the nose has been operated on.
Closed rhinoplasty is suitable for straightening (removing humps) and reducing the size of the nose. Shortening of the columella and delicate shaping of a plump nasal tip can also be performed using this technique. The advantage of the closed technique is not only the absence of all visible scars from the outside, but also faster healing and swelling of the nose.
In the open technique, a small hidden scar will be visible after a year only with the greatest effort, so it is not a real limitation of the technique. However, with open rhinoplasty, it takes a little longer for the nose to become swollen.
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Whether this slight swelling is bothersome is associated with major individual differences. If the tip of the nose was very wide and was narrowed during the operation, the postoperative swelling is much less disturbing than if an already narrow tip of the nose is operated on, which appears somewhat swollen for about three months after the operation. The transition to the pretty new nose is thus often more natural and inconspicuous, but also requires a little more patience.
The great advantage of open rhinoplasty is the absolute control over the tip of the nose, i.e. the cartilage that forms the outer nasal framework and the nasal entrance. If asymmetries are present, if the nose has already been operated on, or if the nose has been altered by trauma, the open technique often allows a better assessment of which underlying disorders need to be eliminated.
The open technique also offers the possibility of inserting so-called “grafts” and placing them in exactly the right place, i.e. shapes of the tip of the nose with placeholders that further embellish the outer shape of the nose.
The decision whether to perform a closed or open technique is made jointly after a detailed presentation of the opportunities and options offered by the respective surgical technique.
