Rhinoplasty Specific Issues
“Open” vs. “Closed” techniques – Reconstructive Rhinoplasty
These terms refer to the creation of a small incision under the tip of the nose or the absence of it.
There are times when creating this incision allows for better exposure and an overall better result. Other times it isn’t necessary. Dr. Frankel uses an “open” approach approximately 65% of the time on revision rhinoplasty cases. Advantages with the “open” techniques are increased visualization for analysis and maneuvering the cartilages as well as placement of any sutures or grafts that may be necessary. Disadvantages are increased post operative swelling for a longer period of time. The “closed” technique offers less swelling
but with less exposure at the tip it may limit what the surgeon can do and how accurately maneuvers are performed. The determination of which technique to apply will depend on your specific nose. Dr. Frankel is well trained in both and uses each method regularly.
Learn more about issues associated with rhinoplasty and browse the site to learn more about Dr. Franke and his offices in Los Angeles.
Many people have difficulty breathing from their nose as a result of rhinoplasty surgery.
Valva collapse inhale
Valva collapse resting
In addition to being a board certified Facial Plastic and Reconstructive Surgeon, Dr. Frankel is also a board certified Otolaryngologist (Ear Nose and Throat specialist) and has specific training in treating people with breathing problems. Dr. Frankel believes that function and form of the nose are intimately related and he always puts an emphasis on improving or maintaining nasal function. Occasionally medicine can be helpful or sometimes new technology can be applied in lieu of, or addition to, surgery.
Following surgery to remove cancer or occasionally following facial trauma, the nose may be left severely disfigured due to the lack of tissue that has been removed or lost. Reconstructive rhinoplasty refers to surgery required to restore tissue that is absent or has been damaged beyond repair. Tissue replacement is usually thought of in terms of replacing the three layers of the nose: 1) the outer skin-soft tissue envelope including skin, subcutaneous tissue and fascia, 2) the middle foundation layer or bone-cartilage framework and 3) the inner mucosal lining. Surgical repair requires the use of grafts and flaps from various parts of the body to restore the missing component tissues. The overall reconstructive process typically requires multiple staged surgical procedures. Again, both the surgeon and patient need to understand the limitations in the final outcome that such deformities are associated with.