Dr. Kaniff performs several different approaches to nasal surgery. The choice depends on the complexity of the changes needed.

1. Closed Rhinoplasty (Endonasal Approach)

Closed rhinoplasty, also known as an endonasal approach or incisionless rhinoplasty, is the technique preferred by Dr. Kaniff for most primary surgeries.

• Technique: All incisions are hidden entirely inside the nose. Through these internal incisions, the nasal skin is carefully separated from the underlying bone and cartilage. This allows Dr. Kaniff to access and modify the nasal structure.

• Procedure: Bony humps can be reduced, irregularities smoothed, and nasal bones straightened or narrowed. Nasal cartilages are shaped and supported using various specialized techniques. The skin is then re-draped, and the incisions are closed with dissolvable sutures.
• Recovery: An external splint is removed after one week. Bruising is possible but often subsides significantly within the first week with proper post-operative care. Approximately 80% of swelling resolves over the first two to three weeks, and 90% within 12 weeks. Final swelling can take a year or longer, depending on the thickness of the nasal skin.

2. Open Rhinoplasty (External Approach)

Open rhinoplasty, also known as an external rhinoplasty, provides greater visibility for complex structural work.

• Technique: This approach uses internal incisions plus a small, precise skin incision across the columella (the strip of tissue separating the nostrils).
• Advantage: The columellar incision allows the surgeon to lift the skin, providing better visualization of the nasal tip cartilages and underlying structure. This visibility is essential when more advanced structural grafting techniques are necessary.
• Application: Open rhinoplasty is often utilized for complex cases, especially in revision rhinoplasty surgery.
• Recovery: While the columellar incision usually heals well, swelling after an open rhinoplasty may last slightly longer than with the closed approach.

3. Tip Rhinoplasty

Tip rhinoplasty is a focused surgery addressing changes limited to the lower third of the nose.

• Focus: The procedure is confined to the nasal tip cartilages, modifying their shape, rotation, and projection.
• Recovery: Bruising is typically less extensive, and swelling is concentrated in the nasal tip area.
• Note: While specialized, tip rhinoplasty is not as commonly performed in isolation, as changes to the tip often necessitate modifications to other aspects of the nose to maintain overall facial harmony.

4. Revision Rhinoplasty

Revision rhinoplasty is surgery performed on a nose that has undergone at least one previous rhinoplasty.

• Complexity: This procedure is significantly more difficult and takes longer due to the presence of scar tissue and structural alterations from the prior surgery.
• Considerations: Because of the increased complexity, revision rhinoplasty is typically more expensive. Depending on the extent of work required, post-operative swelling may also last longer than after the initial procedure.

5. Non-Surgical Rhinoplasty (Noninvasive)

Non-surgical rhinoplasty offers temporary, non-permanent changes using injectable materials.

• Technique: This method involves the injection of dermal fillers to add volume to the nose, allowing the surgeon to camouflage minor undesirable attributes like small bumps or irregularities.
• Limitations: The extent of possible changes is limited, and the results are temporary, usually lasting several months.
• Risks: While less invasive, this procedure carries risks related to the blood supply to the nose, which is a key consideration for Dr. Kaniff, especially in patients with prior surgery or trauma. This treatment is used only in limited, appropriate situations.