Open, closed and ultrasonic rhinoplasty, septorhinoplasty, non-surgical nose reshaping. In the first consultation many patients arrive with these terms mixed together, and it makes sense: they name different things that are sometimes used as synonyms.
In this guide I explain what each one means, what it corrects and in which cases it is indicated, so that you arrive at the consultation knowing what we are talking about.
By goal: cosmetic rhinoplasty, functional rhinoplasty and septorhinoplasty
The first classification has to do with what is meant to be corrected.
Cosmetic rhinoplasty. It modifies the shape: the profile, the tip, the width, the projection. Its goal is to harmonize the nose with the rest of the face.
Functional rhinoplasty. It corrects what makes breathing difficult, such as a deviation of the septum or alterations of the internal structures.
Septorhinoplasty. It is the combination of the two: it corrects shape and function in the same surgical time. It is common, because many noses that are cosmetically bothersome also have a breathing component that the patient has normalized over the years.
By approach: open and closed rhinoplasty
The second classification has to do with how the structure of the nose is accessed.
Closed approach. All the incisions stay inside the nose. It leaves no external scar and it is used in cases where the work required is more limited.
Open approach. It adds a small incision in the columella, the skin that separates the nostrils. It gives a direct view of the whole structure, which allows more precise work when it is necessary to reconstruct, graft or correct marked asymmetries. The scar tends to become less visible over time.
The choice is not a matter of style preference: it depends on what needs to be done in your nose.
By technique: ultrasonic rhinoplasty and conventional rhinoplasty
The third classification has to do with the instrument used to work on the bone.
Conventional rhinoplasty. It shapes the bone with hammer and chisel, the technique that has been used to operate for decades.
Ultrasonic rhinoplasty. It works on the bone with high-frequency vibration, which acts on the bone tissue without damaging the skin or the surrounding vessels. It makes it possible to sculpt the dorsum with more precision and with less trauma to the tissues, which usually translates into less bruising in the first days.
I am one of the first surgeons in Colombia to incorporate this technique, and today it is the one I use to operate on most of my cases.
Revision or secondary rhinoplasty
It is the one performed on a nose that has already been operated on before, once or several times. It is not a repetition of the first surgery: it is a different scenario, with scar tissue, modified anatomy and, frequently, a lack of cartilage to reconstruct with.
That is why it usually requires grafts, sometimes from the rib, and a longer surgical time. It also demands more patience: a recently operated nose needs time before it can be operated on again.
Non-surgical nose reshaping with hyaluronic acid: rhinoplasty without surgery
Non-surgical nose reshaping is not a rhinoplasty. It is the application of hyaluronic acid to camouflage small irregularities of the dorsum or to slightly improve the projection of the tip.
It can be a good option if what you are unhappy with is very specific, if you want to see a change before deciding on surgery, or if for some reason you are not a candidate for the operating room at this time.
It does not work to reduce the size of the nose, it does not correct a deviation, it does not improve breathing and it does not replace a rhinoplasty. It is temporary and it must be applied with medical judgment and knowledge of nasal anatomy, because this is an area with real vascular risks.
Non-surgical nose reshaping or rhinoplasty: how to decide
The simple way to put it is this.
If what bothers you is a small irregularity in the profile and you like everything else, non-surgical nose reshaping can solve it temporarily.
If what you want is a smaller, more defined nose, to correct a deviation or to breathe better, you need surgery. Hyaluronic acid adds volume, it does not take it away, and in a wide nose it can end up making it look wider.
If you have already had hyaluronic acid applied and you are thinking about having surgery, mention it in the consultation. It is information that changes the surgical plan.
Rhinoplasty in men
The technique is the same; the aesthetic criteria are not. In a male nose the goal is usually to correct without feminizing: a straighter dorsum is preserved, a less rotated tip, and over-reduction is avoided.
It is an increasingly frequent consultation, and the conversation about what result is being sought is as important as the technique.
Thick skin noses: why technique is not everything
A significant share of the patients I see in Barranquilla have thick skin, weak cartilage and a wide nasal base. In these noses technique alone is not enough: no matter how much the structure is refined, thick skin tends not to let that definition show.
There, what changes the result is the support. I use cartilage grafts to structure the nose, and when the cartilage from the septum is not enough, a rib graft. The expectation also changes: in this kind of skin the result is revealed more slowly.
Frequently asked questions
Find the answers to the most common questions here.
What is a septorhinoplasty?
It is the surgery that corrects the shape of the nose and, in the same procedure, the deviated septum that makes breathing difficult.
Which is better, open or closed rhinoplasty?
Neither is better in the abstract. The closed approach avoids the external scar and works for more limited procedures; the open approach gives a direct view and is the one indicated when it is necessary to reconstruct or graft. It is decided according to your nose.
Does ultrasonic rhinoplasty hurt less?
It is usually associated with less bruising and a more manageable recovery in the first days, because it is gentler on the soft tissues. Pain is managed with the prescribed regimen in any case.
How long does non-surgical nose reshaping with hyaluronic acid last?
It is a temporary result that is reabsorbed over time. How long it lasts varies according to the product used and according to each patient.
How much does non-surgical nose reshaping cost?
I do not publish prices on the site. The price is defined in the consultation according to the product and the amount your case requires.
How long does recovery from a septorhinoplasty take?
You need a few days of initial rest and a gradual return to your activities. The final shape of the nose is refined over the following months.
Can I have nose surgery if I have already had hyaluronic acid applied?
In general yes, but it has to be assessed. It is important that you report what was applied to you and when, because it can change the surgical plan.
What type of rhinoplasty do I need?
That is defined by examining your nose on the outside and on the inside. The plan comes out of the consultation: approach, technique and whether grafts are required.
