Dorsal hump excision can be accomplished through a closed or open rhinoplasty technique. The surgical approach chosen depends on the etiology of the nasal hump and other rhinoplasty maneuvers incorporated into the procedure.
The procedure can be performed under general or local anesthesia. In either case, local anesthesia is injected via an intercartilaginous approach to infiltrate the lateral nasal walls. If septal and tip work are also to be performed, the septum is infiltrated, and a small amount of anesthetic is placed between the domes and subcutaneously in the columella. In delivery or open rhinoplasty approaches, injections are made in the marginal incisions. Injections are not made in the nasal dorsum to prevent any distortion. Generally, less than 8 mL of local anesthetic is required.
FREQUENTLY ASKED QUESTIONS
|Closed Rhinoplasty||Open Rhinoplasty|
|Closed Rhinoplasty refers to a nose job that is performed via internal incisions - i.e., there are no external scars. The surgeon makes one or more incisions along the inside of the nose and lifts the skin up from the nasal framework. Once the skin is elevated, the shape of the nose is changed.||Open Rhinoplasty, on the other hand, uses the same incisions as a closed rhinoplasty with the addition of an incision on the undersurface of the column of tissue that separates the nostrils called the columella. While this places a small scar on the exterior of the nose, in most cases, the incision heals very well and is not noticable at conversational distances. The incisions for the closed rhinoplasty are completely identical to the open with the exception of the incision across the columella.|
• Potentially shorter operative time
• Less swelling of the tip
• No external scar
• Better visualization for the surgeon
• Direct exposure of the anatomic structures
• More precise intraoperative diagnosis
• Less distortion of the nasal framework from intraoperative retraction
• Ideal for complex nasal deformities
|A closed rhinoplasty is where only the cuts inside the nose are made. This was originally developed to be used to fix broken noses, where more refined work on the tip is not usually carried out. If you think your tip is absolutely fine, the closed approach might be right for you.||This 6 mm incision allows the surgeon to peel the skin of the lower nose back to fully visualize the tip and dorsum of the nose. In the closed procedure, there is not as much visualization since the skin is not peeled back.|
|A closed rhinoplasty is usually for minor reshaping.||This approach is used for any rhinoplasty that needs extensive tip or dorsal work.|
Open rhinoplasty is good for a second or third revision whereby extensive scar tissue and cartilage grafting techniques are necessary, and external exposure is needed. A simple primary reduction rhinoplasty is best done closed.
Our plastic surgeon will assess the structure of your nose and profile of your face before he can decide if a closed or open rhinoplasty is suitable for you. Most patients undergone closed rhinoplasty with us.
The nasal splint is removed one week after surgery, and the nose is retaped using adhesive. One week later, the tape is removed, and the patient begins daily taping of the nose for the next several weeks. This taping is performed for at least 2 more weeks after the surgery or for longer if the edema is significant. Taping of the nose is an important postoperative measure because it helps eliminate the dead space between the nasal skeleton and the skin–soft tissue envelope and allows for optimal redraping.