Question : When it comes to deciding between a closed and open revision rhinoplasty, how much of that decision is the patient’s vs. the physician’s?
Answer : When it comes to the technique of the rhinoplasty, I tend to consult with the patient carefully. My preference is to use a closed approach unless an open approach is necessary to get the desired result. Therefore, if I consult with a patient and I tell the patient that an open approach with a small incision is needed to get the best result but they still insist on a closed approach, I have to make sure that they understand that they may not have the same optimal result. In cases where I feel that the result will not be what they expect, I will not perform this surgery. Open rhinoplasty and closed rhinoplasty should not concern the patient because, if done properly, the incision will heal very well with excellent results. I think the patient would be unhappy if someone attempted a closed rhinoplasty with no incision and obtain a very poor result rather than having it done in a correct method.