Open rhinoplasty: aesthetics and function at your service

Modification:
Depending on the patient’s goals and wishes, the surgeon will reshape the bones, cartilage, and/or soft tissues to create the desired shape and function.

Closure:
Once the surgery is over, the doctor stitches the columella (between the nostrils) with a very subtle and thin suture and then will put the nasal cast and nasal packing. Usually, this surgical wound heals perfectly. It will be hardly detectable once the healing period is completed.

How long does it usually take?

The average time of surgery with the open rhinoplasty approach is 1.5 to 3 hours. It can take longer in complicated cases, where the nasal structure requires a lot of modification. 

Previously, the open technique used to take longer, as the suturing would be time-consuming. Nowadays, due to improvements in techniques and more experienced surgeons, the length of the surgery has significantly decreased. Also, the accessibility to the inner structures provided by the open approach can actually reduce the operation duration.

What does an open nose surgery change?

We would like to remind you that rhinoplasty surgical planning is customized for each individual. The type and amount of changes each patient receives are based on their unique facial features and aesthetic goals. For people who need more surgical correction, such as nasal tip refinement techniques, open rhinoplasty is the technique of choice. In functional nose surgeries, like septoplasty to address a deviated nasal septum, surgeons go on with an open rhinoplasty.

In general, changes through an open rhinoplasty approach are:

• Reshape the bridge:
  The size and shape of the nostrils can be modified to balance the overall appearance of the face;
• Change in the shape or size of your nose: 
  The size and shape of the nostrils can be modified to balance the overall appearance of the face;
• Refine the tip: 
  The tip of the nose can be made more refined and lifted for a more aesthetically pleasing appearance;
• Improve breathing: 
  Removes obstructions in the nasal passages and modifies the shape of the septum and/or turbinates.
• Modifications in the nasal angle:
  The angle can be altered by modifying the nasal bridge, the nostrils, and the nasal tip;
• Correct asymmetry: 
  If the nose is asymmetrical, it can correct this imbalance;

For less vast procedures that require less change, like a hump reduction without tip refinement, surgeons may use the closed approach. 

Pros and cons of open rhinoplasty

For a better nasal appearance, choosing the correct surgical approach is crucial. Knowing the advantages and this advantages of the surgical procedure helps patients choose wisely and to set more realistic expectations. Here, we have listed the pros and cons of the external approach.

The benefits of an open rhinoplasty

The advantages of the open approach in both functional and aesthetic rhinoplasty, make it a common practice among nose surgeons. Let’s take a look at these advantages:

Visibility of the nasal structures

The open rhinoplasty approach gives the ability to see the nasal bone and cartilage. The better the doctor can see under the skin surface, the more accurately they can see the nasal deformities. And this leads to a better nose shape.

Direct access to the internal structures of the nose

In addition to the direct vision of the nasal anatomy, another great benefit of open rhinoplasty is maximum exposure to the internal nasal structures. This accessibility helps the surgeon apply the best rhinoplasty techniques, They can correct the deformities in a more subtle and precise way. 

Providing more strength and stability

When the nose surgeon has full visibility of the structures of the nose, they provide more support for the nasal framework. This results in more stability of nasal structures and a better nasal shape.

Educational Value

This is a great advantage for doctors and students who like to have an in-depth learning experience. This detailed understanding of nasal anatomy is an enormous privilege for future nose surgeons.

More experienced surgeons can sharpen their skills, and this will indirectly work in favor of patients. They get to choose from more well-trained surgeons.

The negatives you need to know about

All surgeries have their own disadvantages, and the open rhinoplasty approach is no exception. The disadvantages of this challenging procedure are as followed:

The possibility of increased swelling

Undeniably, open rhinoplasty is a challenging and invasive rhinoplasty approach. In open rhinoplasty, the skin is cut and elevated. This can result in more swelling and bruising. Yet, this edema will subside shortly after. If the patient follows all the post-op instructions, the recovery times won’t be much of a problem. 

Longer surgery duration

The longer the procedure, the more the chances of bruising and edema. Interestingly, some surgeons claim open surgery can be faster due to the vast visibility and accessibility it provides. That’s why it is important to choose the right nose surgeon for your cosmetic procedures.  

External scars

One negative point of the open approach is the possibility of a remaining surgical scar on the columellar skin. Through the right incision and suturing techniques, the scar will not be much conspicuous. An expert rhinoplasty surgeon understands these aesthetic concerns. That’s why through the physical examination, the doctor will do a thorough analysis of the nasal skin. 

As surgical techniques improve, the scars are less likely to be perceptible. According to studies, in recent years about 90% of patients claim the external scars to be not or hardly visible. (1)

Weak nasal frameworks

One downside of open rhinoplasty is the possibility of losing structural stability. As a result, the nasal walls might collapse and revision nose surgery might be needed. Therefore, it is essential to consider a reliable surgeon with high success rates. 

Who can undergo open rhinoplasty?

The final decision on if a patient can get an open rhinoplasty highly depends on two factors: the patient’s preferences and surgical requirements. The surgeon decides if the patient is a candidate for the open approach. A patient should have the following qualifications in order to be eligible for open rhinoplasty:

• At least 16 years old for women and 18 for men;
• In good general health;
• Chronic conditions under control;
• Realistic expectations on what you can and cannot achieve;
• Major cosmetic concerns;
• Major functional change needed;

People who require major changes in their nasal structure might be the ones to benefit the most from this surgical approach. Major changes such as nasal tip alteration or projection of the nose need direct access, therefore open rhinoplasty is the right approach. 

Chronic medical conditions such as diabetes or high blood pressure should be perfectly managed before the operation. Such conditions increase the possibility of scarring and prolonged recovery time.

External rhinoplasty enables the surgeon to make a lot of changes to create the ideal nose shape for your facial harmony. You should know sometimes not every requirement a patient has is not possible to fulfill. Sometimes the nose shape is in contrast with facial balance, and sometimes the nasal anatomy creates restrictions and limitations. Having practical expectations helps achieve the desired aesthetic appearance as well as prevent disappointment. 

How do I know if open rhinoplasty is good for me?

If you are curious to know if this surgical approach is appropriate for you, the best way to find out is to consult with your surgeon. A thorough facial analysis alongside a comprehensive nasal analysis is done to evaluate the necessary changes. 

Here are some factors that may determine if open rhinoplasty is good for you:

• A desire to change the appearance of your nose, such as making it smaller or changing the shape of the tip
• A deviated septum or other structural issues that are affecting your breathing
• The presence of a bump on the nasal bridge
• A nose that is too wide or too narrow

If you’re still not sure about the procedure, you can check out our article where we compare open and closed rhinoplasty techniques to help you with your decision.

What are the open rhinoplasty cost and fees you need to know about?

Undeniably, the cost of the surgery can impact the final decision. In recent years, many popular cosmetic surgery centers have offered world-class services at reasonable prices. On average, the price range of open rhinoplasty can vary greatly and ranges from 3,000 to 10,000$, but the final cost depends on several factors, including the location of the surgery, the surgeon’s expertise, the complexity of the operation, and any additional fees for:

• Anesthesia
• Pre-operative tests
• Medications
• Facility use
• Post-operative care
• Revision surgery or other medical treatments in case of any complications

It’s worth noting that in certain regions, the total price for open rhinoplasty may be inclusive of all expenses, whereas, in other regions, it may only account for the surgeon’s fee. If you’re looking for an affordable way to achieve the nose shape you desire, we will always be happy to answer any further questions you might have.