Freer Nasal Knife — Vestibular Access Variant

Freer Nasal Knife — Vestibular Access Cut

The vestibular-access variant of the Freer knife is sized for the marginal incision used in open-approach rhinoplasty — the incision around the caudal margin of the lower lateral cartilage that liberates the alar tip cartilages for direct work. The blade angle differs from the caudal columellar variant: it follows the curve of the alar margin rather than the straight edge of the septal cartilage.

Why curve matters here

The marginal incision is the cut on which open rhinoplasty depends — too deep and the alar rim is destabilised, too shallow and the lower lateral cartilage cannot be delivered for tip work. The Freer’s curved tip rides the cartilage margin under direct vision and produces an incision that heals as a hairline mark hidden in the natural vestibular fold.

Closure

The corresponding closure with 6-0 fast-absorbing gut places the knot inside the vestibule so it does not need to be removed; the quality of the incision determines whether the closure can be done at all.