Rhinoplasty: Open vs Closed

We advocate a systematic, graduated approach to rhinoplasty in every phase of patient encounter from the pre- to intra to postoperative period. This approach is contingent on three guiding principles: planning, simplicity, and flexibility, which should inform on every rhinoplasty venture. With a detailed plan well thought out in advance, the surgeon may avoid protracted operative time and ill-defined goals. Using the full arsenal of techniques, including delivery, nondelivery, and open approaches (which celebrates the goal of flexibility), the surgeon may select only the ?simplest method that will correct the deformity and thereby reduce unnecessary variables associated with radical dissection and reestablishment of nasal structure. Despite the best efforts, the surgeon should also exercise a systematic review of all his work for as many years as patient compliance permits so as to ensure that all his surgical efforts are enduring.