Open vs. Closed Rhinoplasty

Narasimhan Plastic Surgery

As a rhinoplasty specialist, I see patients at my St. Petersburg, FL, practice who have a wide range of concerns about their noses. Some individuals are self-conscious about the appearance of their nose but have no trouble breathing, while others may require what is called “functional” rhinoplasty to correct structural issues that make it difficult to breathe through their nose.

Whatever the specific reason for performing rhinoplasty, plastic surgeons use either a “closed” or “open” surgical technique. In this post, I’ll briefly explain the different approaches and when one technique is preferred over the other.

Closed Rhinoplasty

When I perform a closed rhinoplasty, I make incisions on the inside of the nostrils. No part of the incisions can be seen so there are no visible scars. A closed approach limits the changes that can be made to the nose’s shape and size because the right and left nostrils remain disconnected. In closed rhinoplasty, the surgeon doesn’t have a direct view of the nasal structures, and the entire operation is performed through the nostrils’ narrow openings.

The advantages of a closed technique include the absence of visible scars and a shorter recovery time. But for many people, the procedure’s limitations outweigh the benefits, so I typically only use the closed approach for simpler rhinoplasty surgeries. For example, making minor refinements to the nasal tip would be considered a “simpler” surgery.

Open Rhinoplasty

This is the method I prefer for most patients because it gives me an unobstructed view of and better access to the nasal structures. Even though some plastic surgeons still prefer the closed approach, most believe this more advanced technique provides enhanced results in virtually all rhinoplasty cases.

In open rhinoplasty, I make a small incision on the columella, the small strip of skin at the front of the nose that divides the nostrils. Over time, the incision fades and is barely visible. After making the incision, I carefully lift the skin to expose the cartilage and nasal structures (which is why it’s called open rhinoplasty). This enhanced view of the nasal structures is ideal for most complex and revision rhinoplasty procedures.

Open rhinoplasty is used for reshaping crooked noses, reducing the nose’s size, and making changes to overprojected, underprojected and bulbous tips. The open approach is also used to smooth out a dorsal hump and gives me a better opportunity to create aesthetically pleasing results.

Seeing the actual results of rhinoplasty is one of the best ways to gauge what you can expect from a plastic surgeon. Take a look at our gallery of rhinoplasty before-and-after photos to see some of my actual patients.

You can also contact us using the online form to request a personal consultation, so I can evaluate your nose and determine the technique that’s best suited for you.

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