Open rhinoplasty adds a small incision across the columella — the skin bridge between the nostrils — to the incisions inside the nose, so that the entire nasal framework can be lifted into direct view. The surgeon works on bone and cartilage under full visual control.
This page explains what open rhinoplasty is, when it is preferred, how the operation proceeds and what recovery involves, including how patients travelling from abroad usually plan their stay in Izmir.
What is open rhinoplasty?
In the external approach the tip skin is raised through the columellar incision. The tip cartilages, the septum and the bridge are then exposed and adjusted under direct vision.
This allows cartilages to be sutured symmetrically, grafts to be placed precisely and complex deformities to be corrected. In exchange, a small external scar remains and tip swelling may take somewhat longer to resolve.
| Feature | Open rhinoplasty |
|---|---|
| Incisions | Inside the nostrils plus columella |
| External scar | A fine line on the columella |
| Surgical view | Complete, direct |
| Cartilage suturing and grafting | Precise placement possible |
| Operating time | Usually longer than the closed technique |
| Typical indications | Tip asymmetry, crooked nose, revision, noses needing grafts |
Who is a candidate?
The open technique comes to the fore when the tip needs extensive reshaping or when the framework has to be structurally reinforced.
| Situation | Why the open approach is considered |
|---|---|
| Marked tip asymmetry, wide or boxy tip | The tip cartilages are shaped with symmetrical sutures under direct vision |
| Crooked (deviated) nose | The septum and cartilage framework must be corrected as a whole |
| Post-traumatic deformity | Fracture lines and displaced fragments are repaired under direct vision |
| Revision rhinoplasty | What the previous operation left behind can only be understood by seeing it |
| Thick tip skin | Support grafts need room to be placed |
| Cleft-lip nose | A complex, asymmetric structure has to be rebuilt |
When the only concern is a dorsal hump and tip support is good, the closed technique may be sufficient; the decision is made at the consultation.
How is the operation performed?
Open rhinoplasty is performed under general anaesthesia and takes 2–3.5 hours; harvesting a graft or adding airway work extends this.
- Incisions inside the nostrils are joined to the broken-line incision across the columella.
- Elevation: the tip skin is gently lifted off the cartilage framework.
- Assessment: cartilages, septum and bridge are inspected and the plan is reviewed one last time.
- The bridge: the hump is reduced and the dorsum refined; osteotomies are performed if needed.
- Septum and airway: deviation is corrected; cartilage is harvested from the septum if grafts are needed.
- The tip: the tip cartilages are shaped with sutures; support and shaping grafts are placed.
- Closure: the skin is laid back, the columella is closed with fine sutures and a splint is applied.
How does the columellar scar heal?
The incision is placed at the narrowest point of the columella. A broken-line design makes it harder for the eye to read the scar as a straight line.
A published meta-analysis found that closing the columellar incision with absorbable or non-absorbable sutures gives similar scar results; what mainly determines the appearance of the scar is the patient's skin type and healing pattern.
| Period | Columellar scar |
|---|---|
| Week 1 | Sutured, slightly red |
| Months 1 – 3 | Pink-red line; sun protection is advised |
| Months 6 – 12 | Fades to a fine line that most patients find hard to notice |
Planning a visit from abroad
| Step | When | What happens |
|---|---|---|
| First contact | Weeks before | Photographs and history shared by e-mail or WhatsApp; preliminary opinion |
| Arrival and consultation | 1 – 2 days before surgery | Examination, endoscopy, photographs, final plan, informed consent |
| Surgery | Day 0 | General anaesthesia; discharge same day or next morning |
| Follow-up | Days 1 – 7 | Wound checks; sutures and splint removed around day 7 |
| Departure | Day 8 – 10 | Flying is usually possible after splint removal |
| Remote follow-up | Months 1 – 12 | Photographs at agreed intervals |
What does recovery look like?
The times below are typical ranges; they vary between individuals and are not a personal guarantee.
| Period | What to expect |
|---|---|
| First 48 hours | Swelling, bruising around the eyes, congestion; head elevated |
| Days 5 – 7 | Splint and columellar sutures removed |
| Days 10 – 14 | Return to desk work for most patients; bruising largely gone |
| Weeks 3 – 4 | Gradual return to sweaty exercise |
| Weeks 6 – 8 | Bone healing largely complete |
| Months 3 – 6 | Most of the swelling has settled |
| Month 12 | Tip swelling resolves; final shape settles |
Avoid blowing the nose, resting glasses on the bridge, sun exposure and smoking during this period.
What are the risks?
The list below is not exhaustive; individual risks are discussed at the consultation and during the informed-consent process.
- Bleeding, infection, anaesthetic risks
- A visible columellar scar or wound-healing problem
- Prolonged tip swelling
- Temporary numbness of the tip
- Asymmetry, unexpected shape, graft displacement
- Change in nasal breathing
- Need for revision
How is the decision made?
At the consultation, tip support, cartilage thickness, skin thickness, the septum and the airway are assessed. On photographs, the changes and the technique best suited to them are discussed.
The open technique provides a more controlled working field for tip asymmetry, deviation, post-traumatic deformity and revision; the external scar and longer tip swelling are weighed against this.
The information on this page is for general guidance only and does not replace a medical consultation. The technique that suits you can only be determined after an in-person examination.
