Comparison of the open and closed revision rhinoplasty surgery.

For the last twenty years there has been a great debate on whether the rhinoplasty operation should be fulfulled in a closed or an open form. The "open" or external approach involves an incision in the columella, or the zone under the tip of the nose. The "closed" or endonasal approach involves a series of incisions inside the nose. We practically always use the open method for revision rhinoplasty. In most cases there is a great deal of asymmetry of the nasal tip cartilages that may need rebuilding and recreating the individual components of the nasal tip.