Is Osteotomy Possible with Closed Rhinoplasty? — Including Worries About General Anesthesia

01

Closed osteotomy — is it actually a feasible surgical method?

Yes, it is. The needed dissection space is created through internal incisions and the osteotomy can then be performed; whether open or closed suits the case is decided by the correction range and internal structure.

> My revision rhinoplasty date is coming up soon. The surgeon explained the plan as closed osteotomy followed by silicone insertion, with tip cartilage tying — but I can't quite understand whether closed osteotomy is actually feasible. I've also never had general anesthesia, so I'm afraid of the anesthesia too.

Osteotomy is fully possible with a closed rhinoplasty approach. Not making a large external skin incision doesn't create a problem for working on the bone. Dissection is done through internal incisions before the osteotomy proceeds, so the surgery itself is not hindered.

02

It's my first general anesthesia — how worried should I be?

General anesthesia risk varies with each person's health status and surgical scope, so you should ask the anesthesia team about your individual risk and contingency plan based on preoperative tests and review of medical history and medications.

• Before surgery — anesthesia is performed after adequate basic testing and status checks.
• During anesthesia — continuous monitoring keeps safety as the top priority.
• Preoperative consultation — discussing the surgical plan you've been given once more with the medical team helps reduce anxiety.

Rather than being excessively anxious, it's better to confirm your questions in the preoperative consultation. What to check before revision is covered in the revision rhinoplasty guide.

03

Can a wide-looking nose improve without an implant? — a tip cartilage tying case

This is a droopy-nose case where the sideways-spreading, bulbous appearance was the concern. Viewed from the front relative to the bridge, the nose also appeared slightly deviated to one side.

When tip cartilage tying is performed to improve a droopy nose, it can naturally support the tip while reducing the force pulling it downward. Because this patient's existing bridge height was sufficient, the plan was to proceed without silicone — implant-free surgery.

After surgery, the bridge line was tidied straight, and the sideways-deviated appearance improved. As the tip line settled smoothly, the protruding impression caused by the bumpy bridge was also balanced out.

One point worth noting: many people assume that if the alae look wide, reduction surgery is mandatory — but as in this case, a spreading appearance often improves with tip cartilage tying alone, without directly reducing the alae.

Rather than simply trimming one specific area, what matters is balancing the whole in consideration of the person's face shape and feature proportions.

04

Summary — resolve doubts about the method before surgery

For both closed osteotomy and general anesthesia, the plan itself is often less the problem than anxiety arising from lack of information. The order is: understand whether the surgery is feasible and how safety is managed, then confirm remaining questions in a preoperative consultation with the medical team. Since revision is a bigger decision than a first surgery, adequate consultation and careful judgment are needed.

Questions about the surgical method or anesthesia can be confirmed in a 1:1 video consultation. Actual correction cases can be seen in before & after photos.