Rhinoplasty began as an inside-out procedure: The external results visible to the world were produced by surgery that took place out of sight —inside the nostrils and beneath the nasal skin, with all incisions and suturing hidden.
Doctors sometimes compare the closed rhinoplasty to pilots “flying on instruments” in cloud cover: They “see” the way forward with their equipment and their training. Others liken it to sliding a hand beneath a sheet, or the proverbial “cat under the blanket”: They track its movement and progress by the raised impression it makes on the surface.
However it’s described, closed or endonasalrhinoplasty is still very much in use today.
Not an Open and Shut Case
The development of an alternative —open rhinoplasty—stirred some debate about which is best, but ultimately what it’s done is given rhinoplasty specialists like Dr. Frankel the flexibility to approach the work in different ways.
In open (external) rhinoplasty, the surgeon performs an incision on the underside of the nose —on the small column of skin between the nostrils —and then lifts the skin up to get a better view. After changes are made, the nose is “closed up” again, and the incision between the nostrils heals.
Some surgeons prefer the open rhinoplasty because it affords that direct view of cartilage, bone and nasal architecture. With a skilled and experienced plastic surgeon, a well-made incision on the skin between the nostrils heals until it is virtually invisible.
Some remain partial to the closed rhinoplasty because by working from beneath the skin, they can see more clearly, in real time, the effect the procedure is having on the undisturbed surface of the nose.
And even though endonasalrhinoplasty is performed “blind,” there’s no risk of visible scarring. Closed rhinoplasties take less time to complete, heal more quickly, and involve a shorter recovery for patients.
Best of Both
Dr. Frankel offers both rhinoplasty techniques, and his experience and judgment allow him to choose the ideal one for each individual patient.
Dr. Frankel is board certified in both Facial Plastic and Reconstructive Surgery as well as Otolaryngology (ENT). He exclusively performs surgery in the face, head, and neck regions. His specialty is rhinoplasty.
You can contact Dr. Frankel at his Beverly Hills, CA, office by calling (310) 552-2173 or with this contact form.