Rhinoplasty can be considered one of the most complex and challenging procedures in cosmetic surgery. The trends over the past decade have shifted away from reduction or division of the cartilage framework of the nose to conserving the native anatomy and augmenting deficient areas to restore balance and structural support.

Primary refers to first – time nasal surgery, whether for cosmetic or functional purposes, as opposed to secondary rhinoplasty, which indicates the patient has had one or more previous surgeries.

Primary rhinoplasty involves removing excess bone or cartilage, augmenting deficient areas and altering the internal nasal structures, thereby improving the structural support of the nose. The final changes may be subtle or dramatic, depending on the needs of the patient.

Primary Rhinoplasty has two major approaches : CLOSED (internal approach) and OPEN (external approach). In the Closed, the nose is approached via an internal incision ( no external visible scars). The surgeon works on the internal nasal structures through this approach. In the Open Rhinoplasty, a very small external incision is made on the columella to open the nose. Most scars resulting from the open rhinoplasty are usually favourable, very rarely conspicuous. This technique allows the surgeon to visualise most areas of the nose and facilitates the procedure, especially in secondary and difficult cases. This approach gives the surgeon a three-dimensional view of the nose, which helps to reorganise the nasal structures.