The last three decades have brought about enormous changes in our approach to reshaping the nose. Years ago, rhinoplasty was considered a simplified technique and most operations were done with a “closed” approach. The closed approach meant that the surgeon made most of their anatomical changes inside the nose almost blindly. We commonly find patients who are unhappy with their nose - it was either made too small, or in many cases, has developed deformities of the cartilage and bones as time has passed.
The newer “open” techniques make primary rhinoplasties more likely to create satisfying outcomes and also allows surgeons to more easily re-examine past procedures.
These new techniques greatly increase the chances of a very good outcome for patients undergoing secondary procedures. In cases where too much cartilage was removed, newer techniques can incorporate cartilage grafts from the patient's nose or their ears to recreate a better-looking result.
The newer surgical techniques also take into account the differences in the shrinkage of the skin between younger and older patients. We can apply the appropriate techniques to obtain the best results from patients in the 20's or in their 60's.