Rhinoplasty incisions are placed along the previously made incisions. An “open” approach is typically required and adds an incision placed across the columella (a structure situated between both nostrils). This site heals imperceptibly in the majority of cases and allows for improved access and visualization of nasal structures under the skin – an especially important consideration in revision surgery. Manipulation of bone and cartilage may require grafting materials from various sites, such as ears (cartilage), rib (cartilage), and temple (fascia) in order to optimally modify and shape the nasal framework. At the conclusion of this operation, internal and external splints are commonly placed to ensure the stability of the nose during the initial healing process.
General anesthesia is most commonly used.