Open Rhinoplasty

Rhinoplasty is one of the cosmetic procedures that has been part of the beauty world, in Thailand and abroad, for centuries. Today it is more popular than ever among people of every gender and age, as cosmetic surgery becomes ever more widely accepted. 2024 is an era of innovation, and technology has advanced so far that techniques now answer patients’ concerns better than ever. So why is the nose at the top of so many people’s lists? Because the nose sits at the centre of the face, it is one of the golden proportions to focus on first. If you want a beautiful face with real dimension, a nose with a well-projected tip and a graceful slope has a huge influence on your overall facial shape. And if your nose has more significant problems, such as a crooked or flat nose, open rhinoplasty can correct abnormalities in the nasal structure. Today we’re sharing everything you need to know about open rhinoplasty – what it is, its benefits, and real review cases at SLC Hospital.

Open Rhinoplasty is a technique that is very popular abroad, because it lets the surgeon refine the nasal structure in detail and precisely to each patient’s wishes. The surgeon makes an incision under the base of the nose together with incisions inside both nostrils, giving access to the internal structure of the nose so it can be shaped as desired, whether that means raising the nasal base, reducing the nasal base, correcting a bulbous “rose-apple” nose, filing the bone, or even repositioning the septum. This makes it a great option for people with quite a few nasal concerns who want a beautifully projected nose with a slope tailored to their wishes.

Because open rhinoplasty can reshape the internal structure of the nose, it is ideal for people who want to change their nose shape noticeably. At SLC Hospital, we offer 3 top techniques to suit your concerns and readiness, so you can choose whichever technique you feel most comfortable with.

1. Silicone with ear cartilage (Cartilage Grafting)

This technique combines silicone with cartilage from behind the ear. Medical-grade silicone is used to raise the nasal bridge, and ear cartilage is stitched in to support the tip of the silicone. Ear cartilage is stronger than soft tissue and supports tension well; it is very safe, has few complications and does not cause rejection reactions. This technique is ideal for people with thin nasal tip skin who want a clearly projected tip.

Benefits: Ear cartilage is strong and safe, with few complications

Ideal for: People with a thin nasal tip who want a clearly projected tip

2. Silicone with rib cartilage (Autologous Bone Grafting)

Another technique combines silicone with rib cartilage. The surgeon raises the nasal bridge with silicone and attaches rib cartilage at the nasal tip. Rib cartilage is stronger than ear cartilage and integrates well with the body, reducing scar tissue formation in people with thin tissue at the nasal tip. This technique suits people with a thin nasal tip and a tight, deformed tip.

Benefits: Rib cartilage is strong and reduces scar tissue formation

Ideal for: People with a thin nasal tip and a tight, deformed tip

3. Your own rib cartilage, no silicone (Rib Cartilage Grafting)

The final technique uses only rib cartilage from your own body. The surgeon harvests rib cartilage from the patient and uses it to build up the nose. The benefits: the body does not react against it, and problems with inflammation, infection and scar tissue are reduced. The result looks beautiful and natural, with good protection against extrusion. It is ideal for people who are allergic to silicone and want rhinoplasty without foreign materials. For people who are allergic to silicone or cannot use their own rib cartilage, the surgeon will recommend medical materials such as “artificial rib cartilage” or “TnR Mesh” instead.

Artificial rib cartilage is a sterilised material with properties similar to real cartilage, helping to reduce inflammation and scar tissue formation.

TnR Mesh is a soft, porous synthetic tissue, suitable for supporting the nasal tip and augmenting the nasal bridge.

Benefits:  No rejection reactions; reduced inflammation, infection and scar tissue

Ideal for: People who are allergic to silicone and want rhinoplasty without foreign materials

Choosing the right rhinoplasty technique and choosing where to have it done are among the most important things to consider. We recommend SLC Hospital as a great option. Beyond our modern medical equipment, we bring together experienced surgeons who specialise in open rhinoplasty, and we have received many awards, so those who have had treatment here have been impressed with both the service and the results.

Open rhinoplasty suits people who want a clearly visible change in the shape of their nose, such as people with an overly high nose, a crooked nose or a nose that is too wide, as well as people who want a higher nasal bridge or more attractively shaped nostrils, because this method allows detailed reshaping of every part of the nose.

Open rhinoplasty is ideal for people who:

1. Want a higher nose
2. Want a smaller nose
3. Want to fix breathing problems
4. Want a more attractive nose shape

In addition, people who have had nose surgery before and want to correct the previous result can also consider open rhinoplasty.

1. General anaesthesia is used so the patient feels no pain during the surgery.
2. The surgeon makes an incision at the base of the nose to access and correct the structure directly.
3. Next, the skin is lifted from the base of the nose up to the septal cartilage (Septal Cartilage), and fat at the nasal tip is removed.
4. If a previous rhinoplasty is being corrected, the surgeon must remove any residual liquid filler.
5. The surgeon corrects the problems to meet the patient’s wishes, for example shaving a hump, narrowing wide nasal bones, trimming the bony base, realigning the nasal bridge, or correcting a deformed, bulging bridge.
6. The structure is adjusted by extending the septum and supporting the nasal tip with cartilage or rib cartilage, depending on the technique agreed with the surgeon from the start.
7. The surgeon closes the incisions meticulously and supports the nose with a splint.

Open rhinoplasty is a delicate and complex technique, but it can reshape the nasal structure to match the patient’s wishes. It exposes the internal structure of the nose in detail so the surgeon can shape the nose from within, producing a clearly changed nose shape. The nasal structure can also be adjusted to address different nose problems in several ways, including septal extension, nasal bone osteotomy, filing the nasal base and surgery to correct the airway.

Lengthening a short nose and projecting the tip with septal extension and septal suturing

The nose is lengthened by repositioning the central septal cartilage. This suits people with a short nasal tip that lacks projection, or a large, wide tip. The surgeon repositions the central septal cartilage to the right point, extending the nose so the tip is higher, more projected and in balance with the bridge. In addition, tip cartilage suturing, or interdomal suturing, suits people with a large, wide tip: suturing the cartilage on both sides of the tip closer together lifts the tip and makes it look slimmer and more refined.

Benefits: Makes the nasal tip look more projected and longer, in balance with the bridge

Ideal for: People with a short nasal tip and a wide nasal tip

Nasal bone osteotomy or nasal bone shaving reduces thick, bulging bone at a fairly wide nasal base along the bridge to make it narrower. The surgeon uses a special medical instrument on the bony base along the bridge to remove excess bone. This requires a great deal of surgical expertise, because bone removed this way cannot be restored. This technique suits people with a wide nasal base, a bulging, crooked or irregular bony bridge, and people who want a slimmer, more refined nose shape.

Benefits: Makes the nasal base look slimmer, balanced and well-defined

Ideal for: People with a wide, bulging, crooked or misshapen nasal base

Shaving or filing the base to reduce a hump (Hump) involves filing down the hump, the bone that bulges in the middle of the nose, to smooth the nasal bone and lower the hump. This lets the implant sit smoothly and snugly. This technique suits people with a high hump, little nasal tissue and a thin nasal tip. Filing a hump requires surgical expertise to make it smooth without damaging the original nasal base.

Benefits: Smooths the nasal base so the implant sits snugly

Ideal for: People with a high nasal hump and little nasal tissue

Airway correction The surgeon adjusts the internal structure of the nose so the base and septum are as normal and straight as possible, correcting the airway in people with a crooked nasal base or a curved, deviated or tilted septum. This requires surgical skill: the surgeon must specialise in nasal structure and have extensive experience in structural rhinoplasty, because not every doctor can perform airway correction.

Benefits: Clears the airway and straightens the septum

Ideal for: People with a crooked nasal base or a deviated septum

Benefits of open rhinoplasty

Open rhinoplasty is a surgical method with many benefits. It can reshape the nose precisely to your wishes, because the surgeon can access the internal structure of the nose to modify and design its shape.

1. Detailed, precise reshaping of the nose Open rhinoplasty lets the surgeon reshape the nose in detail and with precision. With good access to the internal structure, the nose can be designed to the shape you want.
2. Easy access to the internal structure Because open rhinoplasty opens up direct access to the internal structure of the nose for the surgeon, it makes reshaping possible.
3. Suitable for a clearly visible change in nose shape Because it allows detailed reshaping, it suits people with quite a few nasal concerns.
4. Can fix breathing problems at the same time Besides reshaping the nose, open rhinoplasty can also correct airway problems, because the problem areas of the internal structure can be corrected and returned to normal.

Limitations of open rhinoplasty

• A scar remains on the underside of the nose, although it gradually fades over time
• Recovery may take longer than closed surgery
• Higher risk of infection and side effects
• Costs may be higher than closed surgery

At SLC Hospital, we have a team of surgeons with extensive rhinoplasty experience. The techniques used in open rhinoplasty are specialised and require a great deal of surgical skill. The hospital also places beauty that comes with safety first, so you can be confident of quality when you have treatment here.

Frequently asked questions (Q&A)

Q: Is open rhinoplasty dangerous?

A: Open rhinoplasty at SLC Hospital is performed by experienced surgeons in a facility that meets standards, and the hospital has also received the AACI award, so you can be confident of its safety.

Q: When will the scar fade?

A: The scar from open rhinoplasty gradually fades over time, usually taking about 6 months to 1 year, depending on each person’s recovery.

Q: How long is the recovery period?

A: Recovery after open rhinoplasty is generally 1-2 weeks. You may need to wear tape or a nasal splint at first and avoid strenuous activity for a while.

So, have you got all the information you need? We hope it helps you decide, at least a little. SLC Hospital would love to be your choice: besides modern, standard-compliant equipment, we bring together some of the country’s top surgeons. If you’re interested, contact SLC Hospital for a consultation through any of our channels. We’re also easy to reach, right in the heart of Bangkok, so coming in for an onsite consultation couldn’t be easier.