The Merits of the External Rhinoplasty

Overview

The authors present their views on why they continue to perform rhinoplasty through the open approach despite renewed attention to the endonasal alternative. They explore the benefits they attribute to the open technique and discuss the criticisms made of it, alongside their broader views on rhinoplasty.

Sections of note

• Viewpoint article; the abstract reports no patient numbers, no outcomes, no complication rates and no follow up.
• The stated benefits are unparalleled exposure of the nasal structures.
• A further stated benefit is the opportunity for technical precision.
• The authors also claim a better ability to preserve nasal function.
• The criticisms of the open technique are presented and discussed, though not listed in the abstract.
• The article also examines the authors' thoughts on rhinoplasty as a whole.

What it means for a patient

• Open rhinoplasty adds a small incision across the strip between the nostrils, which leaves an external scar, in exchange for direct view of the structures.
• Endonasal rhinoplasty avoids that scar but limits what the surgeon can see and manipulate directly.
• This is opinion. No comparison data between the two approaches is reported.

Why this paper matters

The open approach has been dominant for decades, and the preservation movement revived interest in endonasal technique, making the choice a live debate again. This article states the case for the open side. It offers no evidence on whether results differ between the two.

Terms

• External or open rhinoplasty: surgery through an incision across the columella, lifting the nasal skin.
• Endonasal rhinoplasty: surgery through incisions inside the nose only.
• Exposure: how much of the nasal framework the surgeon can see and reach.
• Nasal function: how well air passes through the nose.