Theerathorn clinic, more than 20 years of experience in rhinoplasty
Open Reconstruction or Open Rhinoplasty is a small incision on the underside of the nose between the nostrils. Nasal structure, silicone, silk, or various foreign bodies in the nose will be found. It is also suitable for correcting various irregular nose shapes. Such as crooked nose, large nasal hump, snub nose, short nose, hooked nose, deformed nose, wide nose base, septal perforation by silicone, narrow nose tip, small nose, etc. This is a method to correct the nose shape that normal rhinoplasty or “Close Rhinoplasty” can’t be done.
Rhinoplasty or reconstruction by using rib cartilage can fix various problems, and can adjust the shape of the nose without limits.
Celebrities, beauty queens and models who performed open rhinoplasty with Dr. Gun.
K. Jesse Ward – Net Idol and famous model.
K. Mimi Kanlayarat Katiya – female lead
K. Marima Supatra – 4th runner up Miss Grand Thailand 2022 and Miss Tourism International 2022
K. Jenny Onnicha Akrasevaya – Model
K. Jenny Onnicha Akrasevaya – DJ and famous net idol, more than million followers.
K. Bell Sawanya Leangprasit – female lead
K. Tina Thanawan Wigg – 2nd Runner-up Miss Grand Thailand 2022 and 3rd Runner-up The Miss Globe 2022
K. Som-o Watcharaporn Pothikasikorn – Miss Grand Lopburi 2017
K.Pam Pamela Pasinetti – 1st place Miss Grand Thailand 2017
K. Neng Kulthida Yenprasert – 1st place Miss Thailand Universe 2000
K.Cherry Melissa – 1st place Miss Thailand World 2006
K.Debbie (Bazoo) – singer
Guaranteed by celebrities, beauty queens, net idols and business people to reinforce their confidence in Dr.Gun’s skills.
Theerathorn clinic is located in Bangkok and most trusted by celebrities, business models for rhinoplasty.
Dr. Gun used to be invited to educate about open reconstruction to aesthetic doctors in Thailand.
Dr. Gun was also invited to be a speaker and demonstrator of open reconstruction in a difficult case in Cambodia in 2022. He had attracted the attention of plastic surgeons from all around the world.
Enhance your nose to be beautiful and prominent, by augmenting the nose with silicone implant grade.
Open Rhinoplasty / Open Reconstruction
✓ Using your own ear cartilage or rib cartilage.
✓ Make your nose more beautiful with your desired shape as your request.
✓ Correct various irregular nose shapes. Such as crooked nose, large nasal hump, snub nose, short nose, hooked nose, deformed nose, wide nose base, septal perforation by silicone, narrow nose tip, small nose, etc.
✓ Reduce the size or reshape the nose.
✓ Correct breathing problems caused by a deviated septum or other structural abnormalities.
5 Most Popular Nose Shapes at Theerathorn clinic
We have many nose shapes such as Korean, Western, Teardrop, Slopes, Straight, etc. After the patient has chosen a shape, Dr. Gun will recommend and adjust the shape to best suit the patient’s face shape. It will boost a distinctive naturalness and enhance physiognomy. More importantly, the safest is our number 1 priority.
The most popular nose shapes at Theerathorn clinic are:
Western Slope Style
The shape is cute with a long tip. Slope only the upper bridge. Filled with a teardrop tip. It’s a western style which is suitable for actors, models or anyone who wants a western style nose shape.
Slope and Upturned Nose Tip Style
The sloped nose bridge looks cute because the nostrils are slightly visible and the tip of the nose is slightly teardrop-shaped. It will enhance the look of a cute and charming like young lady.
Slope and Pointed Nose Tip Style
This nose shape will help you look beautiful and stylish. It is ideal for traders or business owners.
Sharp and Slender Nose Bridge Style
This nose shape is straight, slender and slight teardrop-shaped. You will look majestic and respectful. It is suitable for executives or managers.
Slope and Teardrop Style
It’s a natural look. The nose bridge is not very high and slightly sloping like a baby’s nose. This nose shape will make your face look younger.
Close Rhinoplasty with Silicone
It is a popular rhinoplasty technique in Thailand. It is a surgery on the bridge and tip of the nose with silicone to make it higher. The surgical wound is hidden inside the nose. The silicone used is L-shaped to lift the tip of the nose to increase the bulge of the nose tip as well. It must be designed for the patient appropriately due to the high chance of nasal perforation. it is suitable for noses that have good structure but want to add prominence.
Open Rhinoplasty or Open Reconstruction will focus on the reconstruction of the structure. For example, cartilage remodeling, nasal septum straightening, nasal septal deviation correction, deviated cartilage, and large or humped nasal tip. Open rhinoplasty will open an incision at the front of the nasal septum to clearly see the structure for surgery. The cartilage of the body will be used to adjust the structure of the nose.
Open rhinoplasty has both silicone-free and 100% silicone-free tips. The silicone-free tip around the bridge of the nose usually uses an I-shaped silicone. It is a hybrid technique that can design a nose shape without limits.
Read more: The difference between open rhinoplasty vs close rhinoplasty
Open Rhinoplasty or Open Reconstruction can straighten and lift the nose tip with septal cartilage. It is the only bone in the body that is flat and strong. The doctor will surgically remove only 2/3 of the cartilage in the middle of the nose for the nose tip surgery. Septal cartilage will safely elongate the tip of the nose. It can be used by other cartilages in the body. There are three popular types of cartilage:
Wound behind the ear after 6 months / Image of ear cartilage
1. Ear Cartilage
There are 2 surgical incisions, a normal nasal septum and an incision that made to remove the cartilage behind the ear. The incision is hidden in the crease of the ear, making it invisible. The concha area will be selected by the doctor. A doctor who is skilled enough will be able to remove the right amount of cartilage that does not deform the shape of the ear.
The main structural part for lengthening the nose is to septal cartilage and stitching to the original nasal septum in order to lengthen the nasal septum naturally. It will emphasize the nasal prominence safely without silicone usage. It can enhance and adjust the nose tip more than normal silicone. It also reduces the chance of perforation even more.
2 cm incision on the ribs / Image of the ribs for rhinoplasty.
2. Rib Cartilage
It is an advanced technique that can solve most problems by using the ribs. At present, there are 3 types of ribs that are commonly used in rhinoplasty: self-ribs, donated ribs, and synthetic ribs.
The doctor will make an incision under the breast about 2 cm to remove about 1 rib, then divide more than 10 pieces and subdivide another 10-20 pieces to structure and reshape the nose. It’s a difficult and complicated method. It is suitable for people who want to have surgery only once, in case of multiple rhinoplasty or severe abnormality. It requires surgery under general anesthesia under the supervision of a skilled physician and takes longer than other techniques.
Artificial rib cartilage or rib cartilage from overseas donors come in many brands and qualities. They vary in size and are more fragile than the ribs themselves.
Synthetic rib or PCL Mesh stands for Polycaprolactone Mesh. It is a medical material that has been used for a long time. Nowadays, it is used for rhinoplasty because it can replaces the patient’s real cartilage. It is suitable for people who don’t want to use cartilage in their body.
I-shaped silicone (top) and Gore-Tex (bottom) for rhinoplasty
3. Other Open Rhinoplasties
It may be an L- or I-shaped silicone augmentation that extends from the ridge to the tip of the nose, covering the top layer of the nasal structure. This technique will create a prominent nose shape. It can correct the short nose, and the tip of the nose will be decorated with material such as Gore-Tex or ear cartilage. The tip of the nose will look natural and reduce the problem of seeing joints from inserting silicone. This technique is not suitable for people with thin skin or who have previously had inflammation from nose surgery. It may cause thin and clear nose tip problems in the future.
Using internal cartilage to restructure your nose will give you more beautiful and safer. Both of them have differences and limitations that must be used to suit each problem.
Open rhinoplasty can solve a variety of nasal problems. Dr. Gun and medical team have experience in open rhinoplasty or open reconstruction more than 10,000 cases in more than 20 years. We can summarize the characteristics of the nose as follows.
- The patient has had rhinoplasty over 12 times using the nasal cartilage which has been damaged in multiple locations.
- The core cartilage is S-shaped and has no core septum.
- The patient’s nose used to go through and the tip of nose was thin and there was a lot of fascia.
- Use own ribs to fix the crooked core partition using the 3 pillars technique to make the structure stronger.
- Repair alar cartilage and anterior leg cartilage, then add 5 layers of rib cartilage at the tip of the nose.
- Place 2 layers of nasal tip cartilage and hone the new silicone with extra height, then sew with a sling technique to make the tip of the nose more protruding.
The nose or nasal bone is too big or squat.
Read more: Which clinic is best to fix a big nose “to make it slim and beautiful”?
- It can be made smaller by removing the fat at the tip of the nose and Latteral Spanning Suture.
- Place Batten Graft and 8 layers of cartilage and stretch the septum.
The way to fix big nose tip and excessive fat is to reduce the nose tip fat.
- The patient has undergone rhinoplasty up to 5 times.
- Last time, rhinoplasty at Korea used her own cartilage ribs.
- But the result is inner structure collapsed, a hooked nose tip, and difficulty breathing.
- The difficulty is that the fascia accumulates and the structure is dismantled. Dr.Gun can fix by redoing the ribs and demolish all new structures.
- The inner core of the crooked nose will be made smaller by placing the left and right spreader grafts and setting up a pair of new center pillars and placing the Columellar strut with rib cartilage, then placing 5 layers of rib cartilage at the tip of the nose.
- The difficulty is to remove the ribs without damaging the core cartilage. It can lengthen the nose up to 1 cm.
- The patient wanted to look like “Winter” from “Aespa”, a famous singer from Korea
- She had never had plastic surgery before. Her original nose was slanted, broad base and had large hump.
Read more: What is the hump?
- Cut the hump to narrow the bone at the base of the nose.
- Adjust the core cartilage in consideration of the nasal breathing function and stretch the nasal septum.
- Place Batten Graft, Columellar and 4 layers of cartilage. Due to the young age of the patient, the rib cartilage cannot be used.
How to fix the pinky nose tip.
- The facial structure is so crooked. As a result, the nasal axis is deformed.
- Her bones are big and crooked and humpy. The base of the nose is wide and the tip of the nose is flat.
- Cut the hump, nail the base and straighten the nasal septum and place the Batten Graft.
- Support the tip of the nose with cartilage behind the ear.
- Place the Columellar strut and suture the Interfoot, Intercrus and Interdome by adjusting the distorted septum using Scrolling Technique.
Read more: Tips for nose surgery to look younger (Patients with tilting silicone problems).
Previously, the patient had done thread lifting before.
Read more: Can I get rhinoplasty after nose thread lift?
- Use the Open technique, cut the hump, nail the base and straighten the nasal septum and place the Batten Graft.
- Support the tip of the nose with cartilage behind the ear.
- Place the Columellar strut and suture the Interfoot, Intercrus and Interdome by adjusting the distorted septum using Scrolling Technique.
- The patient used to inject liquid silicone 10 years ago.
- Now the patient has rhinitis, redness on the nose and silicone resulting in a deformed nose that looks abnormally swollen.
Read more: Why do nose filler corrections cost so much?
- Cut the fascia and fluid to stretch the nasal septum.
- Place 1 pillar and Columella Strut, then place 3 layers of cartilage at the tip of the nose.
The tip of the nose is thin. The nose is hooked and the nasal core is crooked.
- Stretch the nasal septum, then place a Batten Graft.
- Support the tip of the nose with 4 layers of ear cartilage.
- Place Columella Strut, then bring the tissue in the nose to repair the skin around the tip of the nose that is thin and clear.
The nose is severely deformed and dented by an accident.
- Excise the fascia and slurry, then straighten the nasal septum.
- Place 1 pillar and place Columella Strut and 3 layers of cartilage at the tip of the nose.
- The patient has had rhinoplasty 2 times, the first time was using close rhinoplasty.
- The patient has a large nose tip.
- The 2nd rhinoplasty has been well studied. If the patient wants to reduce the size of the nose, it must be Open Rhinoplasty only.
- The patient decides to choose Open Rhinoplasty with a famous clinic. But what the patient received was a deformed nostril and cartilage protruding from the nasal septum.
- Caused by fascia holding the front leg cartilage and leg cartilage is torn. Cartilage protrudes from the septum, which causes the nostrils to deform.
- The patient has already used ear cartilage on 1.
Read more: What causes crooked nostrils from rhinoplasty and is it necessary to be fixed?
- Gun fixed it by straightening the crooked nasal septum.
- Place the Batten Graft and reconstruct the front leg cartilage.
- Repair the torn Alar cartilage, then place 4 layers of cartilage at the tip of the nose.
- The patient has a distorted facial structure causing the nasal shaft to be crooked and deformed.
- The patient has a crooked core, high hump and wide base of the nose.
- The patient has a flat nose tip and less flesh.
- Cutting the hump, nailing the base and stretching the nasal septum.
- Place Batten Graf, then support the tip of the nose with the cartilage behind the ear.
- Place the Columella Strut and stitch the Interfoot, Intercrus and Interdome stitches.
- Adjust the distorted nasal septum with Scrolling Technique.
There are various types of crooked nose structures, for example, S-shaped nasal axis and straight nasal axis but sideways are slanted.
How to fix a crooked nose.
- The patient has a large nasal base and a hump.
- Even if the patient has had an open rhinoplasty and has had a hump cut before, the nose still looks short without any slope.
- Stretch the nasal septum, nail the base and place the Columella Strut.
- Batten Graft is placed and Alar cartilage is stitched to make it longer and more prominent.
Characteristics of those who have a wide and suitable nose base.
Pre- and post structure of nasal septum straightening.
Materials for stretching the septum include ear cartilage, 6th or 7th rib cartilage, and septum cartilage.
The patient has a crooked nasal core, a low nasal bridge, a hooked nasal tip, and less nasal flesh.
Read more:: Is there a shape that is suitable for a person with less flesh on the nose?
- Stretch the nasal septum and place the Batten Graft.
- Place Columella Strut and 5 layers of ear cartilage at the tip of the nose.
Read more: The problem of an abnormally upturned nose that many clinics do not accept until meeting with “Dr.Gun”.
- The patient has a severely constricted nose and uneven nostrils.
- The patient has a wound around the tip of the nose and the nasal shaft is crooked and short.
Read more: Is the cartilage dangerously penetrated and how can I reduce the risk?
- Fixed with own rib cartilage by setting the Spreader Graft and placing 3 poles, then connect the cartilage on both sides.
- Place the rib cartilage and fix both nostrils and place the Columella Strut.
- Surgery to correct nostrils with Composite Graft technique.
- Place 10 layers of rib cartilage at the tip of the nose, then cut the silicone and place it extra high, and support the tip with 2 layers of artificial tissue.
- Place 3 layers of the rib membrane at the tip of the nose and stretch the Columella Flap, then lengthen the tip of the nose.
The patient has a hooked nasal tip, severely deviated core, soft nasal septum and hump.
- Place the Spreader Graft on both sides and then set up a large Columella Strut.
- Place 3 layers of rib cartilage at the tip of the nose, then hammer the bone to narrow and cut the hump.
- The patient has undergone 4 nose surgeries, 2 times with silicone and the 3rd time with ear cartilage surgery.
- But because the crooked nose. The patient decided to go back to the same place and fixed the nose by using the same ear cartilage, but has more problems with shortness of breath and constricted nostrils, especially on the right side.
- Caused by crooked cartilage. Nose Internal Valve is narrow.
- The left alar cartilage was covered by silicone until it folded downward and the right anterior femur disappeared.
- Stretch the nasal septum and then place the Batten Graft SCG.
- Repair the left alar cartilage and rebuild the right anterior leg cartilage.
- Place 4 layers of nasal tip cartilage
The open rhinoplasty without silicone on nose tip is combined with open rhinoplasty with ear cartilage or rib cartilage. It is suitable for those who have a big hump and high nose bridge. It includes people who don’t want to insert silicone. It can be replaced with a special Gore-Tex tissue. In the case of people with high humps, the doctor removes the bony arches and smoothens the surface. The permanently removed bone will no longer bulge. The bridge of the nose will look more sloped, beautiful and soft.
The 100% without silicone is suitable for people with a hooked nose tip or a high nose bridge. The doctors will use the open rhinoplasty technique together with hump reduction to reduce the height of the nasal bridge and nose tip, then decorate with ear cartilage or rib cartilage.
- Reshape the patient’s nose better and more completely because the doctor can see the internal structure clearly.
- Reshape the nose tip with natural cartilage and reduce the chance of silicone distortion and perforation in the future.
- Align the new core cartilage to be higher and stronger and stretch the nasal tip better than close rhinoplasty.
- Suture the Interfoot, Intercrus and Interdome to provide a prominent nose and a strong base.
- Reshape the bridge of the nose to be slim and design the desired shape as much as possible.
- Doing only once can last a lifetime.
- There will be a slight wound in the middle of the nose, but it will gradually disappear in about 3-6 months and can be covered with cosmetics.
- The price is higher than close rhinoplasty but it is safer. In addition, doctors must have highly experienced.
Preparation before rhinoplasty.
It is very important to let your doctor know if you have any medical conditions, allergies or any medications you are taking, especially aspirin or ibuprofen. The surgeon will be able to plan a safe operation. You should also take care of your health with the following:
- Refrain from smoking and alcoholic beverages.
- Refrain from taking all kinds of vitamins.
- Refrain from wearing makeup and should wash your hair before surgery.
- Refrain from eating 8 hours before surgery.
- Refrain from marijuana 1 month before surgery and 3 months after surgery (it will affect the delivery of sleeping pills)
Self-care videos after rhinoplasty
How to treat wounds around the nose
You may experience pain in your nose and face. You should sleep on a higher level and avoid sleeping on your side. You will need to apply a cold compress for 3 days after surgery to reduce swelling and continue warm compress for about a week. At first, you may bleed at the surgical site. You can dab it with a light saline solution to clean the wound and prevent infection, and take medication as prescribed by your doctor.
How to treat a surgical wound behind the ear
You should clean the wound with saline and betadine. Don’t sleep on your back and sleep on your side to avoid pressure. The wound must refrain from contact with water for 14 days or until the wound is completely closed. You should take any antiseptic and pain medication prescribed by your doctor.
How to treat a surgical wound around the ribs
Soreness is normal. You should take antibiotics and pain relievers as prescribed by your doctor. You need to avoid contact with water until the wound is completely closed. You’ll need to keep applying scar-reducing medication regularly to prevent keloid scars, and avoid heavy lifting for 14 days after surgery.
Read more: 12 Do’s and Don’ts After Open Rhinoplasty
For 7 days after open rhinoplasty, you should eat the softest food and refrain from taking supplements such as collagen, vitamins, and detox. You can take supplements as usual after 7 days.
- Refrain from eating spicy foods that cause mucus.
- Refrain from eating a lot of salty or sodium food because it can cause swelling and the wound may become infected.
- Refrain from alcohol and smoking.
- Refrain from fermented things such as shrimp paste, Kimchi, rice noodles, fermented fish, pickled bamboo shoots, pickled salmon.
- Refrain from undercooked food such as Sashimi, Larb, and Koi.
- Refrain from all kinds of seafood.
- Refrain from Durian, Jackfruit and Longan.
- Refrain from all kinds of eggs.
Foods that can be eaten after rhinoplasty
- Fried Rice with Pork/Chicken (no egg)
- Noodles with pork/chicken/beef (do not add more seasonings such as fish sauce or vinegar)
- Stir fried basil with pork/chicken/beef (no fried egg)
- Stir-fried kale with crispy pork, sliced pork, minced pork
- Stir-fried garlic with pork/chicken/beef
- Stir fried mixed vegetables with pork/chicken/beef
- Stir-fried sweet and sour sauce with pork/chicken/beef
- Chicken Rice/ Roasted Pork Rice/ Crispy Pork Rice/ Pork Leg Rice (no egg)
- Cucumber soup with vermicelli and minced pork and shiitake mushrooms (no tofu, eggs and seaweed)
- Stewed Pork/Chicken/Beef Rice
- Snapper, Tilapia, Snakehead, Red Tilapia Fish, Catfish steamed with soy sauce
- KFC, Texas Chicken, Chester’s Grill, Mcdonald, Bonchon, Five Star Grilled Chicken (Refrain from pickled radish or pickled vegetables or seafood dishes and eggs)
- Suki, Shabu, BBQ (no pickled vegetables or seafood and eggs)
- Japanese food such as ramen, kara-age fried chicken, gyoza, curry (no raw fish, pickled radish, pickled vegetables, seafood and eggs)
- Spicy mixed vegetable soup (do not add shrimp paste, fermented fish and shrimp)
- All Isaan foods (no fermented fish, bamboo shoot soup, pickles, dried shrimp or raw meat. You should not add additional condiments such as fish sauce or vinegar).
- Vegetable salad without eggs (clear dressing)
- Stir-fried morning glory
- Stewed Duck and Stewed Pork
- Coconut Milk Soup with Chicken
- Pork/Chicken/Beef Steak
- Sausage sandwich, shredded pork, ham, cheese (no chili paste, shrimp paste and crab stick from sea fish)
- Spaghetti with tomato sauce and Carbonara
- Thai pudding with coconut topping
- Thai caramel toffee
- Caramelized crisps
- Cantaloupe & Corn Tapioca
- Sago with Coconut
- Rice Cracker
- Glutinous Rice Balls with Coconut Milk (No eggs)
- Sticky Rice
- Black Beans
- Khao Tom Mud
- Mung Beans Boiled with Sugar
- Coconut Milk Jelly
- Coconut Rice Pancake
- Sweet Water Chestnuts
- Deletable Imitation Fruits
- Steamed Pandan Layer Cake
- Thai Coconut Milk Custard. (Avoid dessert made from eggs as the main ingredient)
- Cake, Bread
- Fruit Tart
- Shaved Ice
- Crepe (No Egg)
- Fruit Jam
- Ice Cream
You can eat anything (except durian, jackfruit and longan as they are very gassy and can cause oral ulcers).
- Fruit juice
- Soy Milk, Tofu milk
- Tea or coffee
- Fermented milk (no cow’s milk because it may stimulate allergy)
- Pumpkin juice, Centella asiatica juice, coconut juice (recommended)
Dr.Gun or Dr. Rattarut Barrameechaiphach, he is a medical professor specializing in open reconstruction. He has almost 20 years of expertise in the beauty industry.
He is one of the pioneers of open rhinoplasty in Thailand.
He has studied and combined science and art to design the face shape and nose shape to satisfy the patient. The most according to the Fibonacci ratio principle. He can also boost physiognomy according to the patient’s needs based on individual identity because he strongly believes that every woman has her own beauty. If you are looking for a nose surgery or rhinoplasty clinic in Bangkok, Teerathorn clinic is a good choice.
🏆 Awarded the No. 1 clinic in open rhinoplasty in 2022 from SUDSAPDA BEAUTY AWARDS.
🏆 Theerathorn clinic has been ranked as Thaitopclinic’s top clinic for open reconstruction.
🏆 Open reconstruction skills guaranteed by Wongnai.
Open rhinoplasty with rib cartilage is taking about 1 rib to be broken down into 16-20 sub-parts. It is enough to reshape the nasal structure and no more ear cartilage is needed.
Yes, it has a chance. Therefore, you should prevent it by avoiding picking up the scab and applying the scar reducer regularly.
Read more: How to prevent and treat keloids?
It is both silicone and non-silicone. In most cases, we only use 20-30% of the silicone around the bridge of the nose. In some cases that already have a nose bridge, it can be done without silicone.
- Alloderm is a synthetic sponge-like material. It can reshape the tip of the nose or stimulate tissue regeneration and can be used in thin-skin cases or as an augmentation to prevent skin perforation. It is popular both in Thailand and abroad. But in the long run, Alloderm may collapse which results in a flattened nose.
- The cartilage behind the ear comes from the patient himself. It is strong and less prone to allergies. It won’t collapse in the long run and looks natural. It can reshape of the nose tip more than Alloderm.
Yes, it is possible. It is suitable for those who have a hooked nose tip or a high nose bridge. We will use the open technique together with hump removal to reduce the height of the nose bridge and reshape the tip with ear cartilage or rib cartilage.
• It depends on the technique and experience of the doctor. However, we take security very seriously. All cases will be operated by highly experienced doctors and we will use silicone only 20-30% to ensure long-term safety.
You should refrain from washing your hair until the wound has healed completely or as advised by your doctor.
It can last a lifetime because the silicone implants do not expire.
We have a unique technique for cutting rib cartilage. We will leave some of the rib membranes to allow the ribs in that area to regenerate.
Close rhinoplasty will cause a small incision inside the nose. It’s suitable for people with a slight nose problem. Open rhinoplasty will cause an incision at the base of the nose to reveal the entire structure. It can fix all kinds of nasal problems. In conclusion, the nose shape will look more natural than close rhinoplasty.