External marginal approach rhinoplasty (EMA rhinoplasty)

Abstract

Background: Open rhinoplasty has been the mainstream rhinoplasty era up to now. Open rhinoplasty supposedly has the great advantage of giving the surgeon better vision and access. However, the columellar scar is one of the worst disadvantages of open rhinoplasty. For patients seeking beauty of the nose, the columellar scar, which marks the operative procedure, is undesirable. Closed rhinoplasty has several advantages such as less swelling and an undetectable scar. However, this technique also has drawbacks, such as limited operative field. Modified open rhinoplasty without transcolumellar incision is introduced here as an extended marginal approach. This extended marginal approach can achieve the best of both the open and closed techniques. The modified incisional technique allows almost the same exposure as that of the open rhinoplastic field, but involves no transcolumellar incision. Autologous graft is the best choice of rhinoplasty with this modified extended endonasal approach. Extended marginal approach rhinoplasty can replace traditional open rhinoplasty.