Open Rhinoplasty in Seattle

Facial harmony is often about proportion, not perfection. When a nose feels too prominent, wide, or simply out of balance with other features, it can impact self-confidence. Open rhinoplasty in Seattle, performed by Dr. Javad Sajan, addresses these concerns. His approach emphasizes natural contouring, stability, and proportion so that the nose complements the face.

Open rhinoplasty is a surgical method used to reshape the nose through a small incision at the base of the nose between the nostrils, called the columella. Along with hidden internal incisions, this small opening allows Dr. Sajan to lift the nasal skin and directly see the underlying bone and cartilage. With a clear view of the nose’s structure, he can make precise adjustments to the bridge, tip, and septum, securing changes with sutures or grafts as needed for balanced, natural results.

Dr. Sajan follows a simple principle: the technique should fit the patient. Faces differ in skin thickness, cartilage strength, bony width, and airway anatomy; a single standard will not address every goal. Open rhinoplasty allows him to adjust and refine each detail, whether it’s reshaping a wide tip, smoothing a bump on the bridge, straightening a deviated septum, or improving overall balance. His goal is to create a natural result that fits seamlessly with the patient’s facial features from every angle.

Both open and closed rhinoplasty reshape the nose but differ in how the surgeon accesses the underlying structure. Understanding these differences can explain why one method may be better suited for certain goals.

Surgical Access

Open rhinoplasty involves a small incision at the base of the nose between the nostrils, in addition to internal incisions. This allows Dr. Sajan to gently lift the nasal skin for a full view of the framework. Closed rhinoplasty keeps all incisions inside the nose, which limits visibility but avoids an external opening.

Visibility and Precision

With open rhinoplasty, the surgeon can directly see the nasal bones and cartilage, making it a good option for complex corrections. Closed rhinoplasty relies on touch and indirect visualization, which works best for smaller refinements.

Scarring and Recovery

The tiny external incision used in open rhinoplasty typically heals as a thin, barely noticeable line. Recovery times are similar for both methods; swelling depends more on the extent of internal work than on the incision itself.

Choosing the Right Technique

Patients looking for subtle adjustments, like minor tip definition or small contour changes, may be good candidates for closed rhinoplasty. Those seeking more detailed reshaping, structural correction, or revision surgery often benefit from the precision and visibility of open rhinoplasty.

Open rhinoplasty can be paired with ultrasonic tools, called “piezo” or ultrasonic rhinoplasty, to refine the bony vault with controlled precision. Instead of traditional rasps and chisels, ultrasonic devices use high-frequency vibrations to sculpt bone while sparing soft tissues. This can translate to fine-tuned contouring, reduced collateral trauma, and smoother transitions along the bridge.

Open rhinoplasty can be planned to harmonize several visual components of the nose and face:

• Dorsal contour Softening a prominent hump or smoothing “open roof” irregularities after dorsal work. Ultrasonic contouring can refine transitions between the nasal bones and upper lateral cartilages, helping the bridge flow into the brow and tip.
• Nasal tip shapeDefining a bulbous or boxy tip, narrowing wide domes, and improving tip projection or rotation using suture techniques and measured cartilage modification. The objective is to create a defined yet natural tip that aligns with the upper lip and columella.
• Width and symmetryBringing overly wide nasal bones inward with controlled osteotomies, balancing nostril shape, and addressing deviations so the nose aligns with midline facial structures.
• Profile balance and facial proportionsCoordinating the nose with the chin and lips improves the side view. In some plans, subtle chin augmentation or fat grafting to the midface is considered to achieve overall balance; open rhinoplasty focuses on the nose but remains part of a holistic facial strategy.

A consultation helps determine if open rhinoplasty is the right choice by reviewing facial structure, goals, medical history, and skin type. This procedure is often considered by patients who want to:

• Smooth a dorsal hump or straighten a crooked bridge.
• Refine the nasal tip for better symmetry or projection.
• Correct results from a previous rhinoplasty (revision).
• Combine cosmetic refinements with breathing or structural improvements.

Factors like skin thickness, cartilage strength, previous injury, and healing tendencies all influence planning.

Open rhinoplasty can provide several benefits for patients seeking precise nasal reshaping:

• Enhanced Visibility: The open technique allows the surgeon to see the nasal cartilage and bone directly, supporting accurate assessment and precise adjustments throughout the procedure.
• Improved Precision: With full access to the nasal framework, the surgeon can make small, controlled changes that improve balance and symmetry while maintaining structural integrity.
• Flexibility in Complex Cases: This approach can be suitable for patients requiring major reshaping, correction of asymmetry, or revision surgery after a previous rhinoplasty.
• Better Support and Long-Term Stability: Direct visibility allows grafts and sutures to be placed more securely, helping preserve nasal structure and maintain results over time.
• Customization for Each Patient: The open approach enables a fully individualized surgical plan that accounts for differences in skin thickness, cartilage strength, and facial proportions.
• Natural, Balanced Results: Because the surgeon can refine details with precision, open rhinoplasty often produces smoother contours and a more natural integration between the nose and surrounding features.

Open rhinoplasty is typically chosen for cases that require more detailed reshaping or correction of complex nasal structures. Along with internal incisions made inside the nostrils, this approach includes a small external incision across the columella (the narrow strip of tissue that separates the nostrils). This provides full visibility of the bone and cartilage framework beneath the skin.

Through these incisions, Dr. Sajan carefully reshapes bone and cartilage to improve both structure and appearance. Depending on the goals of surgery, this may involve:

• Reducing bone or cartilage to refine the size or contour of the nose.
• Repositioning structures to correct a crooked bridge or asymmetry.
• Adding cartilage grafts, often taken from the septum, ear, or rib, to enhance support, projection, or definition.

Each adjustment is planned to create smoother contours, stronger support, and a shape that aligns naturally with the rest of the face. The open technique allows for precise, controlled movements that are particularly important in complex or revision rhinoplasty cases.

Open rhinoplasty remains a common procedure in comprehensive nasal reshaping. At Allure Esthetic, patients choose our Seattle-based practice for our surgical expertise, innovation, and personalized care.

Leadership
Allure Esthetic is led by Dr. Javad Sajan, a plastic surgeon recognized nationally for his work in facial and body procedures.

Personalized Care
Every patient receives an individualized surgical plan. Our team emphasizes open communication, ensuring patients understand their options, techniques, and recovery before moving forward.

Advanced Technology and Recovery Support
Our practice integrates modern innovations such as ultrasonic rhinoplasty and a structured five-phase scar care protocol. Patients can also benefit from 24/7 surgeon access.

Commitment to Respect, Privacy, and Education
Patients are treated with respect and discretion and supported through every stage of their surgical journey. Our team values informed decision-making and long-term trust, ensuring every treatment is aligned with the patient’s health, goals, and well-being.

If you are considering open rhinoplasty and want to learn more about your options, the first step is a personalized consultation with Dr. Sajan. Contact Allure Esthetic in Seattle today to schedule your appointment.

How is open rhinoplasty different from closed rhinoplasty?

Open rhinoplasty uses a small incision across the columella in addition to internal incisions, giving the surgeon a direct view of nasal structures. Closed rhinoplasty uses only internal incisions and relies on indirect visualization.

Will the external incision be visible after I heal?

The columellar incision is designed to heal as a fine line that is difficult to see at conversational distance. Scar quality depends on surgical technique and individual healing. Sun protection and simple scar care routines help optimize the final appearance.

What concerns can open rhinoplasty address?

Common goals include softening a dorsal hump, refining a bulbous or drooping tip, improving symmetry, narrowing or straightening a wide or deviated bridge, and coordinating nasal profile with chin and lip proportions.

What is ultrasonic rhinoplasty and why is it used with open access?

Ultrasonic rhinoplasty uses high-frequency vibration to shape bone precisely while preserving surrounding soft tissues. Paired with open access, it enables controlled dorsal smoothing and symmetric osteotomies with reduced collateral trauma compared to older, more aggressive methods.

How long is recovery after open rhinoplasty?

A splint typically stays in place for about a week. People often return to non-strenuous work in one to two weeks as bruising fades, with swelling improving over several weeks.

Is open rhinoplasty only for cosmetic changes?

Open access is frequently used for cosmetic goals, but it can also facilitate functional corrections such as septal straightening and valve support when appropriate. The plan is individualized; an in-person evaluation determines which steps fit the case.

When is revision rhinoplasty considered?

Revision is discussed after prior surgical changes have matured and healing has stabilized. Open access is useful in revisions to address scar tissue, asymmetry, and structural weaknesses with direct visualization and controlled rebuilding.

How do I decide if I am a candidate for open rhinoplasty?

Dr. Sajan will determine if you are a candidate after assessing anatomy, skin thickness, health history, and goals.

How long do results last?

Open rhinoplasty focuses on balanced reshaping and structural support. While the face and skin continue to age naturally, the underlying framework adjustments are designed with durability in mind.