Open rhinoplasty by paramarginal incision

One of the major handicaps in rhinoplastic surgery has always been the lack of a wide view of the nose's osseocartilaginous structures. In the past, this problem was solved by an open approach, following incision of the columella. This method is not, however, universally accepted since it causes an additional external scar. The open rhinoplasty technique without incision of the columella was adopted in fourteen cases, selected according to type of defect and the need to obtain a wider view of the nose's internal structures. Satisfactory cosmetic and functional results were achieved. No major complications occurred and in all cases the only problem arising was transitory edema in the tip. The authors maintain that the advantage of open rhinoplasty, with wide exposure of the operating area and a more direct view of the alar cartilages and quadrangular cartilage, is that it makes correction of tip and nasal septum defects easier and more precise. This technique also avoids discomfort and the danger of a scar on the columella.