The description of endonasal rhinoplasty: The Closed Approach
Endonasal or closed rhinoplasty was introduced by Doctor Tsope – Vakhtang Khutsidze in 1956. The closed approach in rhinoplasty is made through the nostrils without making any external incisions.
All of the surgical incisions are positioned deep inside the nostrils on the mucous membrane in the area of nasal domes and nose wings, which gives the surgeon an opportunity to peel the skin off from the carcass of nose for further manipulation. The peeled skin is lifted and fixed using special endoscopic instruments in such a way that the surgeon can freely observe the osteochondral frame of nose, including the radix. Although the nose carcass visibility is 100%, the surgeon is free to use a video camera for observing the image on the monitor. Moreover, during the surgery, certain stages of dorsum carcass correction might require usage of endoscopic instruments.