Rhinoplasty Surgical Approaches, The two approaches available for rhinoplasty, or nose-job, surgery. The two approaches are basically that of an internal or external approach. Other names for this are “endonasal” for the internal approach, or “open” for the open or external approach.
The main difference between the two approaches is that of where the incisions are placed. For an endonasal or internal rhinoplasty the incisions are all placed inside of the nose, inside the nostril, so that there is no external scar.
For an open, or external rhinoplasty, the incisions are very similar except that there is one additional incision right along the columella–the little bit of tissue between the two nostrils. So there is a little jagged line scar in that area that allows us to lift the skin up on the tip of the nose, sort of like lifting the hood on a car is how I equate it — and it gives us a bit more open approach — that’s the other name that is used, an open approach.
There’s no right or wrong method necessarily for doing a rhinoplasty and in my hands both approaches have their use. The open approach or external approach is more commonly used in my experience for the patients that I am treating in that I’m able to get a more open or wide view and I’m able to effect the changes that I’m needing to.
The more things that you’re needing to change often the more access that you’ll need in order to make sure that everything is symmetric and as structurally stable as possible. Certainly depending on the changes that we’re shooting for an internal approach with small incisions on the inside is certainly feasible.
There’s numerous patients on my website that have had just an internal approach, or endonasal approach.
I don’t want to sacrifice the ultimate results functionally to do an internal approach where in five years of so perhaps there will be some pinching or scarring that will results as a process of not being able to maintain that support that I want. But I would definitely give you the options available and lead you through the thought processes of why I would suggest one approach versus another.