Rhinoplasty: Open Or Closed?

The choice between the two modalities is the subject of a controversy that has yet to be resolved among the experts.

Cosmetic surgery is increasingly more weight in a society where to look and feel good about yourself is very important. The face is perhaps the most visible part of the body, and specifically, the nose, which according to data from the Spanish Society for Aesthetic and Reconstructive Plastic Surgery, the surgery of this constitutes 20 percent of the interventions requested today in day.

Regarding this type of surgery, there are two ways to perform it, open and closed, and the choice of both is the subject of a controversy that has yet to be resolved among the scientific community, but what are the advantages and disadvantages of each of them?

The open rhinoplasty is performed with an opening between the two fossae (columella), while in the closed one, incisions are made at the access inside them. With the first, the patient is more exposed, and has a longer duration, in addition to the long-term, in the postoperative period, the swelling is long and leaves a small scar.

At the time of the intervention, both options allow to correct the trestle, the tip, and the septum, but before the patient has to undergo a pre-operative, that has two phases: the photos and the medical check-up. At first, the patient performs a photographic study to anticipate the result, and which serves to make consensual planning of the nose design between the doctor and the patient.

Once this study is done, the patient undergoes an analysis with coagulation tests and an electrocardiogram for local anesthesia, while if it is done under general anesthesia (depending on the surgeon’s technique), a chest x-ray is requested. Finally, the patient is advised not to take aspinira during the 15 days prior to the intervention, and, as a supplement, it is recommended to take pineapple juice due to the high potassium content it contains, which favors coagulation.

Things To Take Into Account In The Postoperative

  • -You leave the operating room with the pits covered by antibiotic ointment gauze to control bleeding, as well as a plaster cast that compresses and controls inflammation. In cases of concern about tamponade, endonasal tubes can be left for the passage of air.
  • -After 24 hours, the internal tamponade is removed.
  • -Recovery is not painful even if there is an uncomfortable feeling due to swelling, which lasts a maximum of 48 hours.
  • -The plaster is removed after six days, once the inflammation has disappeared.
  • -Antibiotic, usual amoxicillin is recommended during the four days after the intervention.
  • -An antibiotic ointment must be applied inside, three times a day, and the nostrils must be cleaned with saline solution, using cotton swabs, if necessary.
  • -They do not always occur, but bruising can occur. In this case, they usually disappear between the seventh and tenth days.