Open Rhinoplasty: Combining Function & Aesthetics

Open rhinoplasty is indicated when maximum visibility of the nasal framework is required to correct both aesthetic deformities and functional breathing issues. In patients with post-traumatic nasal deviation or septal collapse, the open approach through a small trans-columellar incision allows precise, three-dimensional correction.

Typical case: a prior nasal fracture with septal deviation leading to airway obstruction. The goal is to straighten and reinforce the septum while reshaping the external nose — all within one surgery.

During the procedure, the septum is exposed, the deviation corrected, and spreader grafts inserted as needed to rebuild the internal nasal valve. The nasal tip is refined using suture techniques and structural columellar grafts for stability. Osteotomies are performed under direct vision, minimizing bruising and achieving a smooth nasal contour.

Swelling peaks during the first two weeks and subsides by week 4. Breathing improves quickly once the internal structures stabilize. The final cosmetic result appears over 6–12 months as soft tissues remodel.