Step-by-Step Open Approach Rhinoplasty

Open-approach rhinoplasty was introduced in 1921 by Rethi, and has since become a well-established practice. As open-approach rhinoplasty has been in use for a long time, it has been refined and thus has many advantages. However, it is also associated with certain complications, such as scarring, poor wound healing, and flap necrosis; moreover, the operation time is long. The closed approach technique is being increasingly used because of the complications of the open approach. However, the open approach is the technique of choice for patients with severe septal and dorsal problems because it allows direct access to, and observation of, the nasal anatomy. Strict adherence to the fundamental principles of open-approach rhinoplasty is necessary to avoid complications. The goal of this chapter is to provide a step-by-step “roadmap” of the performance of open approach rhinoplasty. The various surgical techniques are detailed in individual chapters, and so will not be discussed in this chapter. Surgical dissection and closure of incisions during the open approach will be discussed in this chapter.