There are two approaches to rhinoplasty utilized according to surgeon’s fondness and talent and also the patient’s nose type.
- Closed rhinoplasty approach: it is the initial method of nasal surgery and cosmetic surgeons have taken it for a long time. This method in which columella(central column between nostrils) doesn’t receive incisions and all cuts are suffered through inside the nose has the big advantage of being devoid of any visible scar. The main drawback is absence of direct visualization of inner nasal framework.
- Open rhinoplasty approach: it is the more recent method of nasal surgery in which columella receives cuts and the skin is lifted up and the face is at the direct sight of the surgeon. The downside of this method is necessary incisions at columella and more swelling compared to closed rhinoplasty. However performing at the direct sight of the surgeon makes the outcome more predictable and asymmetric nose and the deformities are easier modified. at the end we remind you of the point that selection of surgical method depends on the surgeon’s opinion and the one at which the surgeon is more skilled. it cannot be broadly said which method is superior. European surgeons often take the closed rhinoplasty. But American surgeons usually perform open rhinoplasty.
Dr. Gharooni prefers open rhinoplasty in which after only one small incision (with 4 millimeter in length) at columella or nasal column, the surgeon gently detaches nasal skin from its underside consisted of nasal bone and cartilage and lift the skin up. Then he brings appropriate changes. For instance, removal of a nasal hump or reducing the nasal tip or diminishing height and length of the nose and also sculpting the nasal bones and cartilage tissues to decrease width of the nose. During all steps the surgeon can redrape the nasal skin to watch closely contours of the nose after alteration which has been made to nasal skeleton and keep taking more actions if necessary. At the end the skin is draped over its original location and very thin stitches are sewn on the scar.