01 Sep Scarless Rhinoplasty (Closed rhinoplasty) Review by Dr. Grigoryants
There are two ways to do rhinoplasty – closed rhinoplasty (sometimes referred to as scarless rhinoplasty) and open rhinoplasty. The main difference is that in open rhinoplasty, an incision is made across the columella and nasal skin is lifted off the nose. In scarless or closed rhinoplasty, all incisions are placed inside the nose.
Is scarless rhinoplasty truly scarless? In my opinion, the term scarless rhinoplasty is a bit misleading because in many cases of closed rhinoplasty, the nostril base would need to be narrowed. It is done by placing a small incision in the nostril base groove on each side. This small incision heals well and very difficult to see in most patients. Not performing alar base (nostril base) reduction when needed will result in wide appearing nostrils and patient dissatisfaction. In those patients who do not need alar base reduction, closed rhinoplasty will truly be scarless.
I prefer closed rhinoplasty for nearly all primary rhinoplasty and most revision rhinoplasty cases. Some difficult revisions, I perform using open rhinoplasty techniques. Having performed numerous rhinoplasties and seen many patients that come to me for revision, I find that open rhinoplasty scars result in visible and indented scars with skin thickening in front of the scar more frequently than thought. In my experience, closed rhinoplasty allows me to perform all the steps that I do in open rhinoplasty including septoplasty, nasal valve repair, dorsal hump reduction, bony base narrowing , and tip reshaping all under direct vision (as in open rhinoplasty). Furthermore, not having the skin lifted off the nose, closed rhinoplasty allows me to get an immediate result of my nasal reshaping and produce more consistent and predictable outcomes. Any patients considering rhinoplasty should make sure that his/her surgeon performs rhinoplasty frequently and able not only to change the shape of the nose but also perform septoplasty when the septum is deviated, repair nasal valve to prevent collapse, reduce enlarged turbinates to open airways.
View our before and after photos here – Dr. Grigoryants rhinoplasty
Learn about nasal valve repair here – Spreader Grafts