Rhinoplasty

Open Rhinoplasty

Open rhinoplasty involves a small incision across the columella—the narrow strip of tissue between the nostrils—along with internal incisions. The surgeon lifts the skin away from the nasal framework, allowing him to directly view and access the underlying structures. It is the preferred approach for complex reshaping, such as:

• Significant tip refinement
• Asymmetry correction
• Structural rebuilding
• Cases requiring precise control of the cartilage

Dr. Wall Jr. is skilled in open structural rhinoplasty with a strong focus on precision and detail, including complex cases he has performed alongside his mentor, Dr. Ronald Gruber.

Closed Rhinoplasty

Closed rhinoplasty uses incisions placed entirely inside the nostrils, leaving no visible external scar. Because it limits how much the overlying skin can be elevated, this technique is best for moderate adjustments, such as:

• Refining a bump on the bridge
• Making targeted tip modifications
• Narrowing the nose when the underlying framework is otherwise sound

The trade-off for the absence of an external scar is somewhat less direct access; however, in the right patient, a closed approach can achieve excellent results with a somewhat shorter recovery.

Structural Rhinoplasty

Structural rhinoplasty refers to any approach that prioritizes rebuilding or reinforcing the cartilage and bone framework that gives the nose its shape and support, rather than just removing or repositioning tissue. This technique is especially important when the nose:

• Lacks adequate structural support
• Has collapsed or weakened cartilage
• Requires significant reshaping that needs to be held in place long-term

Our surgeons may use grafts, often harvested from the patient’s own cartilage, to reinforce the tip, bridge, or lateral walls of the nose. A structural approach is designed for results that support breathing, look natural, and are long-lasting.

Functional Rhinoplasty

Functional rhinoplasty addresses physical obstructions that impair nasal breathing. The most common problem is a deviated septum, where the wall of cartilage and bone separating the two nasal passages impairs airflow through one or both sides.

Functional rhinoplasty may also address enlarged turbinates inside the nose that can swell and block airflow, as well as other physical causes of chronic congestion, difficulty breathing through the nose, or snoring.

In many cases, our surgeons address functional and cosmetic goals together in a single procedure, improving both the appearance and function of the nose.