“Expedition” style mountain-climbing is like open rhinoplasty. It is the more widely practiced form of mountaineering. It involves a large support team to bring supplies and prepare the route up the mountain. It often utilizes the easiest route (rather than the most direct) route to acheive the summit. It is easier to utilize and teach. Unfortunately, it takes a long time and the team swells with people.
Open rhinoplasty is similar. It is how the majority of Plastic Surgeons choose to perform rhinoplasty. The exposure prepares the way. It is easier to learn and teach. It is often intuitive. It will get you a result, but it can come at a price. It requires a scar at the base of the nose. It is often associated with prolonged swelling, which delays the final result. But in the end, and like expedition-style climbing, it will get the job done.
Open rhinoplasty involves an incision at the base of the nose and “lifting” the skin completely off the nose. This often takes hours to accomplish. Now don’t get me wrong, open rhinoplasty is not all bad. I still use the technique in certain circumstances. If a large amount of tip work is required, the open approach is usually best. But in the majority of cases, rhinoplasty can be performed more efficiently and directly, without any external scars, with less down-time, and progression to the final result in a shorter time by utilizing the closed approach.
This view is not universal. Many Plastic Surgeons are only comfortable with open rhinoplasty, and would disagree. I am passionate about noses, so I will stand up for what I believe….