Closed Rhinoplasty Surgery in Udupi

Overview

Rhinoplasty is one of the most popular types of cosmetic surgery that enhances the appearance of your nose. It is a plastic surgery that reshapes your nose by modifying the bone or the cartilage. Popularly known as a “nose job,” it is generally performed as an aesthetic rhinoplasty to improve how your nose looks or a medical rhinoplasty to improve breathing and nasal function. Rhinoplasty can effectively correct a deviated septum or a broken nose. There are two types of rhinoplasty- open and closed.

In this article, we will discuss the closed type of rhinoplasty, its indications, procedure, and complications associated with the surgery, while also exploring the significant differences between an open and closed rhinoplasty.

What is a Closed Rhinoplasty?

Closed rhinoplasty, also known as endonasal rhinoplasty, is a cosmetic procedure that helps alter the size and shape of your nose to enhance your overall appearance. It involves incisions (cuts) made inside the nostrils and the nose, with minimal scarring on the outside. It is a minimally invasive procedure with less swelling and bruising, quick recovery time, and minimal risk of visible scar when compared to open rhinoplasty. Closed rhinoplasty is typically used to reshape the tip of the nose, shorten the nose or it also aids in getting rid of a bump (dorsal hump).

When is a Closed Rhinoplasty Recommended?

Closed rhinoplasty finds its application for various aesthetic and medical reasons as well. It is indicated in the following conditions:

• If the width and length of your nose are not proportionate to the rest of your face, closed rhinoplasty is performed to refine and slim down your nose to enhance the overall appearance of your face.
• Closed rhinoplasty is effective for people with wide nasal bones, bulbous or droopy nose tips, and unequal nasal symmetry.
• Inappropriate nose angle (the angle formed at a point where the nose and forehead meet, and from the nasion to the nose tip). This can make your nose look either short or long.
• Corrects dorsal hump that is a common nasal defect, which is a cartilage and bone irregularity that can distort the appearance of your nose. 
• Sometimes accidents, injuries, and birth defects can alter the shape of your nose, causing septal (thin cartilage that separates both the nostrils) deviations. This can lead to the narrowing of any one of the nostrils causing breathing problems.
• Restoring breathing function that may occur due to any disease, fractures, cancer treatment, injuries or burns.

How is a Closed Rhinoplasty Performed?

Closed rhinoplasty is an in-patient procedure that requires hospitalization for 1 to 2 days, and is usually done under general anesthesia or local anesthesia with sedation. It involves the following steps:

Pre-procedure preparation

• Before undergoing rhinoplasty, you will have a consultation with your surgeon to discuss your specific situation and the result that you desire.
• Your doctor or nurse will take several photographs of your nose from different angles to determine the type of treatment you would require (whether surgical rhinoplasty or non-surgical fillers).
• Your surgeon will record your medical history to rule out pre-existing diseases like diabetes (increased blood sugar levels), and hypertension (high blood pressure) that may delay healing.
• Inform your surgeon about the medications and supplements being taken.
• You will be advised to stop certain medications such as blood thinners (eg: aspirin) for at least 2 weeks before and after the surgery.
• Smoking and alcohol can delay your healing process, hence it is best to avoid it 1 to 2 weeks before and after surgery. Clear instructions will be provided by your surgeon.
• Arrange someone to drive you back home once you are discharged from the hospital. Also, arrange help during your recovery period and you will require rest.

During the procedure

•  Your surgeon will administer general anesthesia, or local anesthesia with sedation.
• Once you are sedated and numb, your surgeon will make small incisions or cuts inside your nostrils.
• The skin is separated from the cartilage to expose the area to be corrected.
• Your surgeon begins the process of reshaping the cartilage, removing or adding bone. 
• A bone graft (artificial bone tissue taken from another part of your body) is used to add the bone.
• The incisions are closed using stitches. 
• The entire procedure takes around 1 to 2 hours. 

Post-procedure 

• You will be given a cast or nose splint for 5 to 7 days which helps to support your nose while healing.
• Rest the day of your surgery and the initial few days after going back home.
• Sleep on your back with your head elevated above the level of your heart to prevent swelling due to the pooling of blood in your nose.
• Your cast is removed after 7 days to reveal your new nose.
• Avoid the following activities for atleast 2 weeks:
  • Strenous exercises
  • Swimming
  • Blowing your nose
  • Drinking alcohol
  • Excessive chewing 
  • Sleeping on your face.
• Recovery takes around 2 to 3 weeks.

What are the Complications of a Closed Rhinoplasty?

Closed rhinoplasty is safe since it is a minimally invasive procedure with quick recovery and faster healing. However, closed rhinoplasty is also associated with certain complications 

• Nosebleeds that could be due to the pooling of excess blood around the surgical site
• A numb nose due to an injury to any nerve near the surgical site
• A asymmetrical nose 
• Breathing difficulties
• Allergic reaction to anesthesia (nausea, dizziness, confusion, and shortness of breath)
• Prolonged inflammation, bruising, and swelling
• Septal perforation (a hole in the cartilage between the right and the left nostril)
• Post-operative deformities requiring repeat surgery
• A change in sense of smell

Open Rhinoplasty vs Closed Rhinoplasty

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