Closed Rhinoplasty: A Single Surgeon Experience of 238 Cases over 2 Years

Area of Science:

• Plastic Surgery
• Otolaryngology
• Aesthetic Surgery

Background:

• Closed rhinoplasty is perceived as less favorable than open rhinoplasty due to visualization limitations.
• Open rhinoplasty is often preferred for enhanced visualization of nasal structures.
• The senior author conducted an audit to evaluate the efficacy of closed rhinoplasty.

Purpose of the Study:

• To audit the outcomes of closed rhinoplasty performed by a single surgeon.
• To determine if closed rhinoplasty retains a significant role in plastic surgery.

Main Methods:

• Retrospective review of closed rhinoplasty operations over a two-year period (2016-2017).
• Independent panel assessment of photographic series for outcomes.
• Statistical analysis using Cohen's Kappa and Friedman test; examination of follow-up, revision rates, and complications.

Main Results:

• 234 out of 242 rhinoplasties were performed using the closed technique.
• High satisfaction scores from consultant surgeons (mean 4.7/5 and 4.3/5) and a lay panel member (mean 4.9/5).
• Substantial agreement among assessors (Cohen's Kappa = 0.72) and a low complication rate (0.8%).

Conclusions:

• The closed rhinoplasty approach demonstrates significant benefits in aesthetic outcomes.
• Both open and closed rhinoplasty techniques are complementary and should be considered.
• Procedure choice should be individualized based on patient anatomy, goals, and surgeon proficiency.