Rhinoplasty is a surgery that is increasingly in demand, especially by men, among whom it is positioned as one of the most requested. After more than nine years of experience, alongside surgeons with a lot of activity, I can say that my experience In this surgery it is not negligible, with about 450-500 nose operations, or rhinoplasties, throughout my entire career. Although, as I said, it is one of the most demanded by men, the percentage of women who undergo rhinoplasty is still higher than the percentage of men. (60% women – 40% men).
The Techniques InRhinoplasty
In the field of rhinoplasty, there are basically two differential techniques, basically depending on the ability to access the nasal structures or approaches.
Open rhinoplasty or closed rhinoplasty?
The nose is like a house of cards.
I like to explain to my patients that the nose is a bit like a house of cards, the moment you touch a “card”, or touch the rest a little, or the castle “does not hold” consistently. The nose works like this; if we touch, for example, the tip because it is what the patient asks for, we must adjust the rest of the structures a little so that the set is perfect and in line.
That said, depending on how much we have to touch, we will choose to have a direct view of the structures or to handle them in a more intuitive way, to say the least, or less visual.
When, for more “simple” issues, we decided to work with a closed approach, that is, without lifting the skin that protects the structures of the nose, we then spoke of closed rhinoplasty.
When we need to visualize the cartilaginous and bone structures for more complex surgery, we will do it with an open approach, we then speak of open rhinoplasty.
The difference between open or closed rhinoplasty, facing the patient, is only that in open rhinoplasty there will be a very small scar on the columella or base of the nose.
Functional rhinoplasty and aesthetic rhinoplasty
We must also distinguish between functional rhinoplasty and cosmetic rhinoplasty.
One thing is a patient who comes and says that he does not like a specific part of his nose, but its functionality is total, that is to say, that he “breathes” perfectly; Another thing is a patient who comes with functional problems accompanied by some aesthetic conditioning. When the problem is merely functional, they usually visit the ENT.