Open Rhinoplasty Surgery

Are you searching for a specialist to handle your open rhinoplasty? Welcome to SurgeonGate, Michigans #1 online destination for learning about cosmetic medicine and reaching premier surgeons. Did you know there are dozens of physicians marketing and performing rhinoplasty in Michigan who are not qualified to do so and do not specialize in this delicate procedure? We are on a mission to make cosmetic surgery safer and more effective by connecting patients with extremely experienced plastic surgeons and highly trained specialists. If you request a consultation below, a specialist will reach out to you as soon as possible to connect you with the most experienced rhinoplasty surgeon in your area. 

Rhinoplasty is one of the most common plastic surgery procedures performed today. Often, the structure or size of the nose is not proportionate to the other facial features. Rhinoplasty procedures can help correct your appearance by changing the size or shape of the nose, the arch of the nostrils, or the angle between the nose and upper lip. In addition, rhinoplasty procedures can be performed to correct congenital nasal defects or injuries as well as chronic respiratory problems.

What is an open rhinoplasty?

There are two surgical techniques, open rhinoplasty and closed rhinoplasty. During an open rhinoplasty, the surgeon makes small incisions through the columella and into each nostril. Unlike a closed rhinoplasty, these incisions allow the doctor to detach the skin from the osteocartilaginous framework of the nose.

By doing so, the surgeon can clearly examine the nasal structure and make precise corrections to its shape and structure. Through the use of special instruments, the surgeon will reshape the nose either by removing or adding bone, cartilage or tissue, in order to achieve the desired appearance.

Anatomy of the nose

Before knowing how rhinoplasty procedures work, it is important that you know the anatomy of the nose. The external nasal portion is basically composed of a framework of bone and cartilage covered by very fine muscles and skin. The nasal bones are located at the root of the nose, below are the triangular cartilages which make up the nasal dorsum or nasal pyramid, and below these are the alar cartilages. These determine the shape and size of the nostrils and the tip of the nose.

The internal nasal portion is not visible and is only accessed by performing an adequate exploration. Illuminating the inside of the nostrils we can see the nasal septum in the center, whose anterior portion is formed by cartilage and the posterior by bone. The superior, middle and inferior turbinates are found in the lateral wall of the nasal cavity. The configuration of the internal portion is extremely important because it is responsible for moistening, heating and filtering the air we breathe and is the cause of most respiratory problems of the upper respiratory tract.

Preparing for an open rhinoplasty

Open rhinoplasty can last between two and four hours. Before starting the surgery, the area to be treated is cleaned and anesthesia is administered. The surgeon may choose to administer local anesthesia and a sedative, thereby numbing the nose and the areas around it and the patient remains awake but drowsy during the procedure. The procedure can also be performed under general anesthesia.

The surgeon makes a small incision through the columella, the tissue located between the nostrils at the base of the nose, and a second incision known as marginal incision, which extends from the incision of the columella and enters in each nostril. 

Through the use of surgical scissors and retraction instruments, the surgeon takes off the skin of the underlying bone and cartilage, to fully expose the structure of the nose, allowing for precise corrections to the nose.

Preparing for an open rhinoplasty

Remodeling the tip of the nose

An open rhinoplasty allows the surgeon to better modify the shape of the tip of the nose. For patients whose nose tip is wide or protruding, the doctor may choose to remove a portion of the alar cartilage from the tip of the nose. Depending on the anatomy of the patient, the surgeon may also use sutures to modify the position of the alar cartilages in order to create a narrower nasal tip.

Removal of the dorsal hump

Frequently, one of the main objectives of open rhinoplasty in Michigan is to eliminate the dorsal hump. Normally, the dorsal hump is constituted mainly by cartilage and bone. To eliminate the dorsal hump, the surgeon may choose to use an osteotome, which is a device similar to a chisel that is used to remove parts of cartilage and bone. In addition, the surgeon may use a delicate surgical rasp to polish the protrusions of the nasal bones.

Open rhinoplasty results and recovery

Osteotomy

An osteotomy involves the fracture of the nasal bones in order to reposition them. The surgeon delicately fractures the bones and reshapes them in a manner that will enhance the aesthetic appearance of the nose. This is the reason many patients experience bruising in the recovery period. Although this is not always necessary, osteotomies can be performed to correct a dorsal hump or reduce the width of the nasal base.

Incision Closure

Once the doctor has completed the nasal remodeling, the incisions inside the nose will be sutured with resorbable sutures. If the bones of the nose were broken during the procedure, a nasal splint will be applied.

The bandages and the splint provide stability and help the tissues heal and adapt to the new osteocartilaginous structure.

Open rhinoplasty recovery

As with any surgical procedure, you are likely to experience some pain, bruising, and swelling, particularly in the upper part of the face and around the eyes. These symptoms will begin to dissipate during the first days after surgery. Stitches, bandages and nasal splints can be maintained for approximately five to seven days. Although most of the swelling will disappear after a few weeks, a slight swelling may persist for a few months.

Results

Depending on your speed of healing, it is likely that you can resume your work between seven and ten days after the procedure. As the swelling of the face disappears, you will begin to notice the effects of the remodeling procedure on your nose. However, as in any other surgical procedure, it is possible that the final results will not be seen until after one year of the surgery. While it is important to emphasize that it is not intended to achieve perfection through nose reshaping procedures, by correcting the proportion and profile of the nose, remodeling can significantly improve your confidence in yourself and your image.

 Advantages of open rhinoplasty

  • The main advantage is that it offers better visualization and accessibility to the nasal structures
  • It allows placing grafts on the back of the nose, providing a more natural look.
  • It allows placing grafts on the tip of the nose, preventing it from losing projection.
  • It allows treating any defect of the nasal tip, narrowing it, defining it, projecting it or deprojecting it.
  • Provide more accurate and predictable results

Disadvantages of open rhinoplasty

  • It is a more aggressive and invasive technique, therefore the recovery is more prolonged and uncomfortable.
  • Unlike closed rhinoplasty, the scar cannot be avoided, although they are usually not very visible, it is a fact that after surgery there will be a scar.
  • With open rhinoplasty, there is an increased risk of bleeding and infections.

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The world of cosmetic surgery is lucrative and greatly unregulated in the state of Michigan. Dermatologists are performing hair transplants and general practitioners are performing liposuction left and right. Technically speaking, you do not need to be a board-certified plastic surgeon to perform plastic and cosmetic surgeries, and this has led to a growing number of complications and unhappy patients.

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