Open Versus Closed Rhinoplasty
A 30-Year Experience

 

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Dr. Clavin has performed a 30-year follow-up on open and closed rhinoplasties to determine what happens with the tip and particularly the tip cartilages over 30 years. There is no question that, as one ages, the nasal tip skin and subcutaneous tissue atrophy and become thinner with time. If the initial surgeon removed too much nasal tip cartilages and, particularly the lower lateral cartilages of the nasal tip, then the tip will become pinched with time. This shows itself 10-30 years following the initial rhinoplasty.

In close follow-up of over 20 years, Dr. Clavin has found that the open technique causes somewhat more thinning of the skin with time versus the closed technique. This can lead to a pinched look appearance 10-30 years later following the initial open rhinoplasty. The same situation can occur following a closed rhinoplasty but not quite as common, since the closed rhinoplasty causes less disruption to the subcutaneous tissue and to the fine attachments of the skin to the delicate nasal tip cartilages. Dr. Clavin suggests from a long-term follow-up that a closed rhinoplasty causes less problem in the future to the nasal tip and that all nasal surgeons should remove less nasal tip cartilages than normally planned to avoid a pinched look 10-30 years later following an initial rhinoplasty.



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Harold D. Clavin, M.D., F.A.C.S.
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