Is the second nose surgery performed as open or closed?

Revision rhinoplasty is a second surgical procedure performed to correct shape or functional issues that arise after the first nasal surgery. This surgery may require more detailed planning compared to the first surgery due to changes in tissue structure, cartilage loss, and healing processes.

This is why revision rhinoplasty may not be suitable for every patient.

The situations in which revision rhinoplasty should be postponed or avoided are explained below.

Is the Second Nose Surgery Closed or Open?

Revision rhinoplasty can be performed both with closed and open techniques; however, in many cases, the open technique is preferred due to the condition of the tissues.

When is Closed Revision Rhinoplasty Possible?

The closed technique can be applied in certain situations:

• If the cartilage structure is preserved
• If there are limited issues with the nasal tip
• If the first surgery didn't involve excessive intervention
• If only minor asymmetries need to be corrected

In these cases, the procedure can be performed without making an external incision.

Why is Open Revision Rhinoplasty More Commonly Used?

In many revision surgeries, the open technique offers a more controlled working area because:

• There may be scar tissue (fibrosis) from the previous surgery
• The cartilage support may have weakened
• The anatomy of the nasal tip may have changed
• A wider field is needed to place new grafts
• Issues such as nasal collapse, deviation, and valve insufficiency can be more thoroughly evaluated using the open technique

Factors Determining the Technique for Revision Rhinoplasty

1) The Technique Used in the First Surgery

If the first surgery was closed, the tissues might be more preserved, and if it was open, a more detailed assessment may be required.

2) Amount of Tissue Loss

If there is cartilage loss, thinning cartilage, or collapse, the open technique might be more suitable.

3) Additional Problems

• Nasal obstruction
• Loss of support in the nasal tip
• Collapse in the nasal bridge

In these cases, the open technique is generally preferred.

4) Need for Grafts

If rib, ear, or septal cartilage is to be used, the open technique usually provides a more controlled working area.

Frequently Asked Questions About Whether Second Nose Surgery Should Be Closed or Open