INCISION APPROACHES

In general, nasal surgery is described as either “closed” (endonasal) or “open” (external). These terms refer to the placement of incisions – closed rhinoplasty incisions are completely hidden inside the nostrils, whereas open rhinoplasty also includes an incision made in the skin between the nostrils.

Some surgeons use the closed technique when the majority of nasal work is performed on the top and the bridge of the nose or if only small modifications are being made to the nasal tip. This is performed through incisions inside the nose. This is a lot simpler to do and results to complete absence of visible scar from the outside. However, the downside of this technique is lack of exposure of the nasal tip. This is commonly used in nasal augmentation using silicone implant.

In Reconstructive Rhinoplasty, the open technique is used. This provides excellent exposure of the nasal anatomy and allows for a more precise rhinoplasty. This requires a very small incision along the thinnest part of the skin (columella) between the nostrils. The incision which is only 3-4mm long normally heals without any visible scar.

Since every nose is different and has unique surgical requirements, Dr. Lansangan discusses the options with each patient and describes the surgical plan in detail. The choice of approach is dependent on what he thinks is the best outcome for the patient and the technical aspects of the procedure.

A. Nasal illustration using open technique

External incision used in “open

External incision used in “open technique"

B. Nasal illustration using closed technique

Intra-nasal incision used in “closed technique

Intra-nasal incision used in “closed technique"