Incision Decision: Weighing Your Rhinoplasty Surgery Options

Rhinoplasty is a complex plastic surgery procedure designed to refine the nose. Although the ultimate goal of any rhinoplasty is to create a balanced and proportional nose, there’s no singular surgical method that is one-size-fits-all for every patient. Rather, surgeons employ a variety of techniques. They also use a variety of incisions to access the nasal structures and position soft tissue. Two methods of the procedure, the closed rhinoplasty, and the open rhinoplasty, are performed using different incision styles.

Dr. Hershcovitch believes that rhinoplasty surgery should be a collaboration between the surgeon and the patient. Rather than just dictating the best course of action for your case, he will explain what your options are and educate you on why each technique is different.

Of course, there’s no harm in coming into your consultation prepared. If you’d like to get a sense of which rhinoplasty technique may be appropriate for your case, we’ve put together a helpful guide to the differences between different rhinoplasty incisions.

Closed Rhinoplasty

A closed rhinoplasty, also known as the endonasal approach, is a technique where the surgeon creates the incisions inside the nostrils; any resulting scarring will be completely hidden.

What Closed Rhinoplasty Can Be Used for

Discretion is important to most of Dr. H’s patients and is one of the reasons why so many would prefer the closed rhinoplasty technique. Unfortunately, it’s not always appropriate. Because it doesn’t offer the best view of the nasal structures, closed rhinoplasties are mostly reserved for straightforward cases – for instance, if a patient merely needed to smooth out a bump on the nasal bridge.

Patients also prefer the closed rhinoplasty because it offers a quicker, milder recovery period.

Open Rhinoplasty

An open rhinoplasty is performed by creating a small incision on the columella, the narrow strip of tissue that divides the nostrils. One the incision is made, your surgeon will gently lift the skin and shape the bone and cartilage. The tissues are then gently repositioned onto the new nasal structure and the incision is closed.

An open rhinoplasty is typically reserved for cases when the surgeon needs in-depth visualization of the nasal structures. Because an open rhinoplasty is often used for extensive manipulation of nasal tissue, it often leads to a longer recovery than a closed rhinoplasty.

What Open Rhinoplasty Can Be Used for

An open rhinoplasty is ideal for cases that require extensive treatment. If patients need the tip of their nose reshaped, a second rhinoplasty, or to strengthen certain structures with grafts, an open rhinoplasty will most likely be used.

Scarring with Open Rhinoplasty

An open rhinoplasty technique will leave a small scar on the columella. Keep in mind – this scar is barely noticeable. The scar will really only be visible if someone is looking up directly at you from below.

As a facial plastic surgeon with extensive training with closing incisions, Dr. Hershcovitch makes sure there is as little tension as possible on the incision to prevent a noticeable scar from forming.

Miscellaneous Incisions

In the case that a patient requires a reduction in the size of their nostrils or narrowing of the width of their nose, we may need to create an incision where the nostrils meet the cheeks. By creating an incision along the natural contours of the nose, we can ensure that any resulting scar will blend seamlessly into your facial features.

What Can I Do to Reduce the Appearance of Scars?

You can do your part to prevent scarring by taking good care of your nose during the healing process. Protect your nose while it’s tender and healing. Make sure to keep your head elevated during the first week of your recovery to reduce swelling and tension on the incisions. Limit your sun exposure to ensure your scars fade as much as possible. You can even take supplements like arnica and bromelain to speed up the healing process.

With all this in mind, we should remind you that the technique isn’t the biggest factor in any rhinoplasty. What matters more is that you find a talented, compassionate surgeon that can help you attain your reasonable goals. Contact the office of Dr. Hershcovitch to learn more about how our experienced and friendly team can help you feel confident about your appearance.