What is Open Rhinoplasty Surgery?
Open rhinoplasty, also known as external rhinoplasty, is a surgical method used to modify the bone and cartilage framework of the nose. This approach involves a small incision made across the columella, the narrow strip of tissue separating the nostrils, in addition to incisions within the nasal cavity. This external incision allows the surgeon to elevate the nasal skin, providing direct visibility and access to the underlying structural anatomy.
The procedure aims to address complex proportional variations, correct significant structural asymmetries, or manage functional breathing concerns by carefully reshaping, reducing, or augmenting the patient’s existing tissue.
What makes a suitable candidate for Open Rhinoplasty Surgery?
A suitable candidate for open rhinoplasty is generally an adult whose facial growth is fully complete and who requires significant structural modifications to the nose. Individuals seeking to alter complex anatomical features, such as a severely deviated septum, significant asymmetry, or prominent tip irregularities, may be appropriate candidates for this approach due to the enhanced visibility it provides the surgeon.
Patients must hold realistic expectations regarding the surgical outcomes and understand that individual anatomy, skin thickness, and healing capabilities dictate the final result. A thorough medical consultation is required to assess whether a patient’s goals necessitate the exposure provided by an open surgical technique.
What are the Open Rhinoplasty Surgery options?
When considering open rhinoplasty, potential options involve cosmetic open rhinoplasty focused on altering the external appearance and proportions of the nose, functional open septorhinoplasty designed to address internal structural abnormalities causing airway obstruction, or a comprehensive approach addressing both form and function simultaneously.
Alternative options include a closed rhinoplasty approach for those requiring less extensive internal modifications, or temporary non-surgical interventions using dermal fillers to add volume to the nasal bridge without undergoing an invasive operation.
Before & Afters
Disclaimer: All surgeries before & afters shown on this website are performed by Dr Mirkazemi and are published with consent by our patients. They are not guarantees that your results will be the same or similar as results will vary between individuals. The content on our page is general in nature and does not constitute medical advice. Any surgery or invasive procedure carries risks and has a recovery time. Before proceeding, please seek medical advice from an appropriately qualified medical practitioner. During your consultation, Dr Mirkazemi will carefully evaluate each individual and provide an honest and realistic assessment of what can be expected from the procedure.
Open Rhinoplasty surgical techniques
- Structural Grafting: This technique involves using autologous cartilage, typically harvested from the patient’s nasal septum, ear, or rib, to provide internal support and alter the foundational framework of the nose.
- Tip Contouring and Refinement: With direct visibility of the lower lateral cartilages, surgeons can meticulously place sutures or remove small amounts of cartilage to modify the projection, rotation, and width of the nasal tip.
- Dorsal Hump Reduction: This involves the precise removal or modification of excess bone and cartilage along the bridge of the nose to alter the patient’s profile and address prominent convexities.
- Open Septoplasty: A functional technique often performed concurrently to straighten a deviated septum under direct visualization, with the aim of managing internal airway obstructions and facilitating nasal breathing.
Recovery after Open Rhinoplasty Surgery
Recovery following open rhinoplasty is a gradual process that varies between individuals, requiring significant patience as the tissues heal.
During week one, patients typically experience the most prominent swelling, bruising around the eyes, and nasal congestion, while wearing an external splint to support the newly modified structures and managing a small suture line on the columella.
By month one, the majority of the visible bruising and primary external swelling generally subsides, allowing patients to return to most normal daily activities, though some localized firm swelling will persist.
By month three, the nasal tissues continue to settle and conform to the altered framework; however, residual swelling, particularly around the nasal tip and the columellar incision, may take up to a year or longer to fully resolve.
How much does Open Rhinoplasty Surgery cost?
The cost of an open rhinoplasty is determined on a case-by-case basis, as the procedure is highly individualized to each patient’s anatomical presentation. The total fee will depend on the complexity of the structural changes required, the specific surgical techniques utilized (such as extensive cartilage grafting), and whether functional airway surgery is performed concurrently.
A comprehensive quote typically includes the surgeon’s fee, the anaesthetist’s fee, hospital or operating facility costs, and any necessary post-operative garments or follow-up appointments. A detailed, personalized financial estimate is provided only following a thorough consultation and assessment by Dr Mirkazemi.
Frequently Asked Questions for Open Rhinoplasty Surgery
Specific Risks and Complications For Open Rhinoplasty Surgery
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
Open rhinoplasty is a surgical procedure performed to modify the internal structure and external contour of the nose. This approach involves a small incision across the columella (the tissue between the nostrils), allowing the surgeon to lift the skin and access the underlying bone and cartilage. While this technique provides high visibility for precise anatomical changes, it is a complex surgery that carries specific clinical risks and potential complications.
The following list outlines possible complications associated with open rhinoplasty. These risks are not exhaustive, and individual healing responses can vary significantly.
Procedure-Specific Complications
- Alteration in Breathing: Surgery on the nasal structure can affect the internal airways. While intended to address anatomical concerns, some patients may experience a change in nasal airflow or a sensation of obstruction.
- Nasal Septal Perforation: In rare instances, a hole may develop in the septum (the wall dividing the nostrils). This can cause whistling sounds, crusting, or nosebleeds and may require surgical repair.
- Skin or Tissue Necrosis: The open approach involves lifting the skin envelope. In rare cases, the blood supply to the nasal skin or the columellar flap may be compromised, leading to tissue loss or significant scarring.
- Asymmetry or Contour Irregularities: Despite precise surgical techniques, the healing of bone and cartilage is unpredictable. This can result in minor asymmetries or palpable irregularities in the nasal bridge or tip.
- Changes in Sensation: Temporary numbness of the nasal tip and upper lip is common. For some patients, these changes in sensation may be prolonged or permanent.
- Reduced Sense of Smell: Some patients report a temporary or, very rarely, permanent reduction in their sense of smell (hyposmia) following surgery.
Long-Term Considerations
- Permanent Scarring: The columellar incision results in a permanent scar. While usually positioned to be discreet, the final appearance depends on individual healing and can occasionally be visible or thickened.
- Persistent Swelling: Swelling, especially in the nasal tip, can persist for 12 to 18 months following an open rhinoplasty. This may delay the visibility of the final anatomical outcome.
- Unsatisfactory Anatomical Outcome: The final result may not fully align with the patient’s anatomical goals due to the way tissues contract and heal over time.
- Need for Secondary (Revision) Surgery: Rhinoplasty has one of the highest revision rates in plastic surgery. Further procedures may be necessary to address minor irregularities, functional issues, or aesthetic asymmetries.
General Surgical Risks
All surgical procedures, including plastic and cosmetic surgery, carry inherent risks and potential complications. These may include infection, bleeding, fluid accumulation, delayed wound healing, scarring, nerve changes, anaesthetic risks, blood clots, and procedure-specific complications. Individual factors such as smoking, elevated BMI, underlying medical conditions, and certain medications can further influence your safety profile and recovery.
A thorough consultation and strict adherence to pre- and post-operative instructions are essential to minimise risks.
