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Beverly Hills Plastic and Cosmetic Surgery “Tip of the Day” from Dr. Francis R Palmer, III Beverly Hills Plastic and Cosmetic Surgeon.

Beverly Hills Plastic and Cosmetic Surgery “Tip of the Day” from Dr. Francis R Palmer, III Beverly Hills Plastic and Cosmetic Surgeon.

I’ve had numerous Rhinoplasty and Revision Rhinoplasty consultations, this week, where the patiens seemed confused about when an Open Rhinioplasty should be done versus a Closed Rhinoplasty…so I though this would be a good time for a brief review of the subject.

In my opinion, you should avoid a Rhinoplasty surgeon who makes claims like “I only do Open Rhinoplasty…or I only do Closed Rhinoplasty.” Why?….because both are viable and important techniques of Rhinoplasty and the surgeon should be able to do both…but select which one is the right technique in your particular case.

When I’m teaching Rhinoplasty to surgical residents I tell them to keep it simple. Open Rhinoplastry is indicated, in my opinion, when there is a very droopy tip as this technique causes a minimum of 5-7 degrees of tip rotation everything else being equal. An Open Rhinoplasty therefore would not be appropriate if the nasal tip was already at the ideal rotation or over-rotated…and if performed would require an additional procedure to place an ear grfat to the nasal tip to rotate the tip back down to the aesthetically correct position.

An Open Rhinoplasty should always be considered when the nasal tip is asymmetric, previousy operated on (previous Rhinoplasty) or otherwise requires the placement of a cartilage graft to the nasal tip. Why?…because an Open Rhinoplasty allows visualization of the tip cartilages as they exist in the nose, allows direct manipulation of these cartilages and allows securing/suturing of the cartilages and/or cartilage grafts under direct visualization….a Closed Rhinoplasty does not!

A Closed Rhinoplasty is indicated for all other issues with the nose…large hump, placement of a dorsal graft, breaking the bones etc can all be done without an Open Rhinoplasty.

The small ioncision along the front of the nose is never a reason, for me, to do or not do an Open Rhinoplasty.

Hope this helps.

Dr. Francis R Palmer, III