A rhinoplasty can be performed using two different types of nasal incisions. One type is called the "Open" approach and involves an incision made across the bridge of skin between the nostrils. The other type is known as the "Closed" or "Endonasal" approach. Dr. Diaz prefers the "Closed" approach in the vast majority of patients. There are situations, however, in which the "Open" approach may be better. During your consultation, Dr. Diaz will discuss the advantages and disadvantages of each and will make his recommendations based on your unique needs.
In this approach, all incisions are hidden inside the nose, so that there are no external scars. This is the technique preferred by Dr. Diaz. One important advantage of this approach is that there are no visible scars. Most patients prefer not to have visible scars, especially in an area as noticeable as the nose. Swelling of the nose also resolves faster with this approach. The lack of external incisions allows more drainage of swelling. This is another important advantage to this approach.
In the Closed approach, all the incisions are made inside the nostrils. There are no external scars visible.
THE CLOSED APPROACH
Click on the video above to see how dr. Diaz performs the closed approach.
THE OPEN APPROACH
The "Open" approach involves making an incision across the thin bridge of skin that runs from the bottom of the nose to the tip of the nose, between the nostrils. This area of the nose is called the "columella." The open approach is a very common way to perform rhinoplasty. Many surgeons prefer this technique because it is easier to see the structures of the nose. A skilled rhinoplasty surgeon can see the structures of the nose just as easily with a closed approach.
In the Open approach, an incision is made across the "columella." This is the thin bridge of skin between the nostrils.
There are several disadvantages with the open approach. One disadvantage is that a scar is created in a visible part of the nose. Although the scar usually heals well, there is a risk it can heal very poorly in some cases, making it very unsightly and noticeable.
Another disadvantage is that swelling can be prolonged when the open approach is used. The reason is that the incision across the columella interferes with the ability of the nose to drain the swelling. Therefore, the swelling may take longer to go away if an open approach is used.
Photo credit: https://www.drtaherian.com/