The closed vs. open rhinoplasty technique concerns only how the surgeon gets inside the nose to make the required changes, not what’s accomplished with the rhinoplasty procedure itself. Reshaping your nose may include breaking and removing bone and cartilage. If cartilage needs to be added, say, to rebuild the tip of the nose, it’s often taken from the septum, the middle portion of the nose—a technique called a cartilage graft. Cartilage may also be taken from other areas of your body, such as your ear. In some cases, a synthetic material, like a silicone implant, is used; but studies have shown that there may be more complications with synthetics. Cartilage grafts, nasal-bone osteotomies (removal of parts of the bone), dorsal-hump removal, and suture techniques applied to the nasal tip cartilages can all be performed with either the closed- or open-approach rhinoplasty.
Case 47: This patient’s primary surgery left her with valve collapse, nostril notching, persistent tip rounding and hanging columella. Secondary surgery involved correction of these issues with repositioning and reconstruction of the tip cartilages to improve tip contour. Although she is still a little swollen in the after photos, she is already happy with her new nose.
The prior”Suits” famous person, who has experienced a nose job to assist her livelihood, starred for seven seasons in hot TV series”Suits.” She’d attended an all-girls Catholic association that is in Los Angeles. It’s shown in a composition she wrote for Elle from the year 2015 her huge round eyes, curly hair, light skin, and freckled face made her stand out among all of her schoolmates.
Case 33: For this young woman, the nose felt boxy and unrefined in comparison to her more defined facial features. Goals of rhinoplasty included lifting and definition of the tip along with subtle hump reduction to create a more sleek and streamlined nasal contour. Achievement of these goals creates a nose that harmonizes rather than dominating other features.
Case 38: This beautiful young lady is an early 6 month example of a finesse rhinoplasty. On front view you can see the bridge is narrower and the sense of hang is improved. On profile, the tip looks undone, natural and less projected with correction of the slight hanging columella. The result is a beautiful, natural look that corrects the issues but leaves her looking totally natural and undone.
The surgeon makes incisions in the skin, usually on the crease under the breast, around the areola and along the underside of the breast. After removing excess skin, the doctor will move the areola and nipple to a new, higher position, pull the skin down to reshape the breast, and then stitch the incisions. Usually, the procedure requires general anesthesia. The American Society of Plastic Surgeons provides a detailed description of the surgery.
If you’re having what’s called an open rhinoplasty, the surgeon will make an incision (about 6 millimeters long) in the skin between the nostrils. “Open rhinoplasty is a very common technique, where the skin is lifted upward like the hood on a car,” says Dr. Ronald Schuster, a Baltimore plastic surgeon, in a RealSelf Q&A about open vs. closed rhinoplasties. If you’re having a closed rhinoplasty, all incisions are placed on the inside of the nose, so there are no external scars.
The results are usually permanent, aside from normal changes that come with the aging process. If you’re really not happy with your results or have breathing difficulties once your nose has healed, you may be a candidate for a revision rhinoplasty. In many cases, scar tissue is the main culprit. “The force of a scar is very strong,” says Dr. Miller. “It can pull a nose one way or another—push it in, pull it out, turn it.” When this happens, a surgeon has to go back in and tweak the work.
Case 26: Narrowing a wide tip can really soften the face. The challenge in Ethnic rhinoplasty is in making a nose smaller while still maintaining good structure and support so that definition is enhanced. In these 15-month photos, you can now see how tip narrowing along with reduction of the bridge convexity has created a very pretty, feminine nose that enhances her beauty.
Case 60: Facial aging can be hard on someone who is naturally thin by creating a more severe and skeletonized appearance as facial fat is lost. A combined approach was used to create a beautiful transformation, including a trichophytic brow lift, lower lid tightening, and facelift along with a conservative rhinoplasty to straighten and balance her nose. Notice how the eyes are opened up and facial hollows are smoothened without the surprised look that can accompany over-aggressive lifts. You’ll also see that incisions are hidden within the hairline and natural skin creases making them almost invisible.
The procedure also does not permanently change the breast shape and firmness. As time marches on, you may expect the effects of aging and gravity to continue. In these cases, a secondary revision surgery may be required. The best candidates for this cosmetic surgery are women who are emotionally well-adjusted, have realistic expectations, and understand the procedure thoroughly.