Open Preservation Rhinoplasty is an open rhinoplasty procedure that applies the principles of Preservation Rhinoplasty to reshape the nose. The approach aims to preserve as much of the suitable native anatomy as possible while modifying only the structures that require correction, rather than completely dismantling or reconstructing the nasal framework.
The term Open refers to a surgical approach involving incisions inside the nostrils and an incision across the columella, allowing the surgeon to directly visualize the internal nasal structures. Preservation, on the other hand, refers to the principle of maintaining suitable existing bone, cartilage, soft tissues, and supporting structures whenever possible.
At Dr. Gorn Aesthetique, Open Preservation Rhinoplasty is planned according to each individual's nasal anatomy and facial proportions. The surgeon evaluates which structures should be preserved and which areas require adjustment to achieve balanced nasal proportions.
What Is Open Preservation Rhinoplasty?
Open Preservation Rhinoplasty combines an Open Approach with the principles of Preservation Rhinoplasty.
The central concept is not to begin by dismantling the entire nasal structure, but rather to evaluate "what is already suitable and can be preserved."
Structures that may be considered for preservation include:
- Suitable existing bone and cartilage along the nasal dorsum
- Existing nasal tip cartilage
- Tissues and ligaments that contribute to nasal support
- The nasal tip support system
- Portions of the nasal septum that do not require correction
- Soft tissues important for nasal shape and movement
The extent of preservation varies according to each individual's anatomy and the concerns requiring correction.
How Is Preservation Rhinoplasty Different from Conventional Rhinoplasty?
Rhinoplasty encompasses a variety of surgical approaches and cannot be classified simply as preservation or non-preservation surgery.
The main principle of Preservation Rhinoplasty is to minimize unnecessary disruption of structures that do not require modification and to maintain the continuity of native anatomy whenever feasible.
Rather than asking only:
"What needs to be removed or reconstructed?"
The preservation approach also considers:
"Which nasal structures are already suitable and should be preserved?"
This approach emphasizes individualized adjustments based on anatomy rather than applying the same surgical technique to every patient.
Why Can Preservation Rhinoplasty Be Performed Using an Open Approach?
Open Rhinoplasty and Preservation Rhinoplasty describe different aspects of nasal surgery.
Open Rhinoplasty refers to the surgical approach used to access and expose the nasal structures.
Preservation Rhinoplasty refers to the principles guiding how those structures are preserved or modified.
Therefore, exposing the nasal anatomy does not mean that the surgeon must dismantle or alter every structure. On the contrary, direct visualization may help the surgeon determine which structures should be preserved and which require modification.
The Principle of "Preserve What Is Good"
The central principle of Preservation Rhinoplasty is to maintain suitable, healthy existing anatomical structures whenever possible.
The surgeon evaluates individual areas, including:
- Which portions of the existing nasal dorsum can be preserved
- Whether the nasal tip cartilage has sufficient shape and structural strength
- Which ligaments and soft tissues do not need to be disturbed
- Which parts of the septum require correction and which can remain intact
- Whether additional grafts are necessary or the existing structures can be utilized
The goal is therefore not to "preserve everything," but to preserve the structures that are appropriate for each individual's surgical needs.
What Is Dorsal Preservation?
One important principle of Preservation Rhinoplasty is maintaining the continuity of the nasal dorsum when the patient's anatomy is suitable.
In certain techniques, instead of directly removing or disrupting the upper dorsal framework, the surgeon may modify other supporting structures to change the height or shape of the nasal bridge while preserving selected components of the original dorsum.
However, several dorsal preservation techniques exist, and they are not suitable for every nose. The surgeon must evaluate the shape of any dorsal hump, nasal bone width, nasal alignment, and septal anatomy before selecting an approach.
What Is Tip Preservation?
Tip Preservation is an approach that aims to maintain suitable existing nasal tip cartilage and supporting structures while minimizing unnecessary cutting or separation of tissues.
If the nasal tip cartilage has good structural quality, the surgeon may be able to refine its shape through repositioning or suture techniques without completely reconstructing the nasal tip framework.
However, if the nasal tip lacks adequate support, has structural abnormalities, or requires significant repositioning, additional structural techniques or grafts may be necessary.
Who May Be Suitable for Open Preservation Rhinoplasty?
Individuals with the following characteristics may consider a surgical assessment:
- Existing nasal structures that are suitable and desirable to preserve
- A desire to refine nasal shape without unnecessarily altering native anatomy
- Certain types of dorsal humps or nasal bridge prominence
- A desire to adjust the nasal dorsum while preserving suitable existing structures
- A desire to refine the nasal tip
- A preference for maintaining distinctive characteristics of the original nose
- A desire for nasal proportions that complement the face without excessive changes
- A previously unoperated nose with native anatomy suitable for preservation techniques
However, suitability depends on the actual anatomical structures. Not every patient can undergo the same extent of preservation.
Is Preservation Rhinoplasty Suitable for Patients Who Have Never Had Nasal Surgery?
Primary Rhinoplasty refers to rhinoplasty performed on a nose that has not previously undergone surgery. These patients often have native anatomy and supporting structures that have not been surgically disturbed, allowing a clearer assessment of the feasibility of preservation techniques.
However, this does not mean that every natural, previously unoperated nose is suitable for Preservation Rhinoplasty.
Significant structural abnormalities, complex nasal deviation, or inadequate support may require additional structural techniques.
Does Open Preservation Rhinoplasty Require Grafts?
Not every patient requires additional grafting materials.
One principle of preservation is to utilize suitable existing anatomical structures whenever possible. However, if additional support or structural refinement is needed, the surgeon may consider autologous cartilage, such as septal cartilage, ear cartilage, or cartilage from another appropriate source when indicated.
Therefore, Preservation Rhinoplasty does not mean that grafts must never be used. Rather, grafting should be based on anatomical needs and surgical objectives.
Does Open Preservation Rhinoplasty Use Silicone Implants?
The use of silicone cannot be determined solely by the term "Preservation," because Preservation Rhinoplasty describes an anatomical and surgical philosophy rather than a specific implant material.
If Open Preservation Rhinoplasty at Dr. Gorn Aesthetique is defined as a procedure focused on modifying native anatomy without using silicone implants, this can be clearly stated as part of the clinic's specific treatment approach.
The actual materials and techniques should be determined after the surgeon evaluates the patient's nasal anatomy.
Does Preservation Rhinoplasty Create a Natural-Looking Nose?
A natural-looking result does not depend on the name of the surgical technique alone. It also depends on the patient's original anatomy, surgical design, and degree of modification.
Preservation Rhinoplasty aims to retain suitable existing structures so that the modified nasal shape remains consistent with the patient's native anatomy and facial features.
The goal is not to create the same nasal shape for every patient, but to refine the nose while preserving appropriate individual characteristics.
Where Are the Incisions for Open Preservation Rhinoplasty?
Because the procedure uses an Open Approach, incisions are made inside the nostrils together with a small incision across the columella, the tissue between the nostrils.
These incisions allow the surgeon to access and directly visualize the internal nasal anatomy.
During the initial healing period, the incision may appear red or remain visible. Its appearance gradually changes as healing progresses, and the final scar varies between individuals.
How Long Is Recovery After Open Preservation Rhinoplasty?
Although Preservation Rhinoplasty aims to minimize unnecessary disruption of nasal structures, it remains a surgical procedure. Swelling, bruising, tightness, or nasal congestion may occur after surgery.
The severity of symptoms and recovery time depend on the extent of adjustments to the nasal bones, cartilage, septum, and surrounding tissues.
The nasal shape gradually changes as swelling subsides. The nasal tip, in particular, may take longer than other areas to settle into its final appearance.
