Open Rhinoplasty

In the open technique the columellar incision is joined with incisions inside the nostrils, and the skin over the tip is lifted gently. This lets the cartilage and bony framework be assessed directly, with both hands, and largely without distorting them.

This wide view may make it easier to compare the symmetry of the framework and to place sutures in a more controlled way. What the approach actually adds is judged during examination, according to the scope of the planned change.

Pronounced deviation, a drooping or asymmetric tip, structural changes following a previous operation, or situations requiring cartilage-graft support may be evaluated for the open technique. Where multi-faceted, detailed correction is planned, the broad view can be an advantage.

For more limited adjustments, the closed technique may also be an option. Which approach is suitable is not decided by a single rule, but by the nose's existing anatomy and the intended outcome.

The incision is made on the underside of the columella skin between the nostrils, usually in a stepped (broken-line) shape, a placement that aims to make the scar less conspicuous. The line, which can be pink and slightly visible in the first weeks, tends to fade and blend in over time.

Scar healing varies with skin type, wound care and individual characteristics. Protecting the incision area and following the care your physician recommends may support the healing process.

Under direct vision, the tip cartilages can be shaped with sutures, and where needed, support and correction may be planned using grafts taken from the person's own cartilage (septum, ear or rib). Adjustments to width in the bony framework or to bridge height can also be made with this technique.

These possibilities are not a promise of any result; which steps are needed and how they are carried out depend on individual planning.

The closed technique offers the advantage of no external scar and often less tissue elevation, but the surgeon's field of view is narrower. The open technique gives direct sight of the structure in return for a small columellar incision, which can be a reason to prefer it in some advanced corrections.

The two methods are not rivals but options answering different needs. The decision is made during examination in İzmir/Bayraklı, weighing the structure of the nose together with expectations.

In the first days there may be swelling over the bridge, bruising around the eyes and a feeling of tightness; the protective splint is usually removed within about a week. The columellar sutures are also removed in this period, and advice such as resting with the head elevated and applying cold can help reduce swelling.

Because the tip skin has been lifted, changes in sensation and refinement at the tip can take a little longer with the open technique; while most of the swelling settles in the first months, the result may take longer to fully settle. The process varies from person to person and is tracked with regular check-ups.