Hybrid Approach for Asian Rhinoplasty: Open Approach Without Transcolumellar Incision

Overview

Open rhinoplasty exposes the framework through a small external incision; the endonasal approach avoids that incision but gives less exposure. This article describes an approach the authors say delivers full access without the external cut, and can be scaled from limited to extensive dissection depending on the case.

Sections of note

• The hybrid approach is stated to deliver unlimited exposure and technical access, enabling all the procedures of the open approach.
• It is flexible in the extent of dissection and exposure used.
• In some cases it functions as a classic endonasal or limited access approach.
• In others it supports open structural rhinoplasty and reconstruction.
• The authors argue the benefits of the nonopen approach deserve equal attention in Asian rhinoplasty practice and in training courses.
• The stated main advantage is not sparing an incision but the ability to fine-tune changes of a few millimeters at every step.
• The abstract reports no patient numbers, outcomes, complication rates, or follow-up.

What it means for a patient

• Full access to the nasal framework does not necessarily require the small scar under the nose.
• The extent of dissection can be scaled to what the individual nose needs.
• The stated benefit is finer control during surgery, which the authors value above avoiding the scar.
• This is a technique description with no measured results, so it does not show the approach performs better.

Why this paper matters

Asian rhinoplasty has been dominated by the open approach because of the structural work involved, and this argues the same work can be done without the external incision. Training implications are the authors' explicit concern. No comparative data supports the claimed advantage.

Terms

• Transcolumellar incision: The small external cut across the strip between the nostrils used in open rhinoplasty.
• Endonasal approach: Surgery done entirely through incisions inside the nostrils.
• Open structural rhinoplasty: Taking the framework apart and rebuilding it with grafts and sutures.
• Exposure: How much of the nasal framework the surgeon can see and reach.
• Dissection: Separating tissue layers to reach the structures being operated on.