Here is some basic information about the nasal anatomy to understand the philosophy of closed rhinoplasty: The main structure of the nose is composed of bone, cartilage, and the soft tissues under the skin.
Since the early times of rhinoplasty, surgeons have been busy with shaping the bony and cartilage tissues mostly. However, nowadays, the importance of soft tissues in addition to the bone and cartilage has been demonstrated.
One of the most important elements of the soft tissue system of the nose is the Pitanguy ligament system. This ligament system progresses under the skin along the back of the nose, passes the tip and holds onto the nasal root at the lips. It is an elastic ligament and is important in the movements and position of the nasal tip. It is in close relationship with the muscle that pulls the nasal tip and the lip downwards.
This ligament is damaged in open rhinoplasty but is protected in closed rhinoplasty. Protection of this ligament has positive effects on the aesthetic and dynamic outcomes.
Since the Pitanguy ligament and the surrounding soft tissues are protected, it is possible to avoid the problem of a frozen nasal tip, which is the situation in many of the patients following open rhinoplasty. We achieve a dynamic and motile nasal tip with the help of the closed technique.
One of the important advantages of closed rhinoplasty is the absence of a visual scar. Currently, patients prefer not to have a visual scar following aesthetic operations. In open rhinoplasty, an incision is made between nostrils and the skeleton of the nose is accessed through this incision. No incision is made in closed rhinoplasty. The operation is performed through the nostrils. The closed technique necessitates experience and is safely performed by experienced surgeons.