Question: My understanding of the difference between open and closed rhinoplasty is that in the closed procedure the incisions are made inside of the nose and that in open rhinoplasty the surgeon also makes incisions on the outside of the nose. I’ve thought about getting a nose job and the closed option definitely sounds like a better idea to me. Is one method preferable to another? Does open rhinoplasty leave any scars?
Answer: Many times patients get really stuck on the open versus closed rhinoplasty approach. At the end of the day these are just simple approaches to the rhinoplasty. It is much more important what the plastic surgeon does actually during the rhinoplasty and not just which approach he chooses. You’re correct that during a closed rhinoplasty all of the incisions are in the inside of the nose and during an open rhinoplasty there is one additional incision made on the columella which is the skin separating the 2 nostrils. This allows the surgeon to pull the skin back and not just simply off of the cartilage and bone. This very small incision if placed properly and close properly should be nearly imperceptible. Please be aware that if nostril reduction is necessary those incisions are independent of either closed or open rhinoplasty technique and those scars may be more visible. There are some great surgeons that do every rhinoplasty through an open approach and there are some great surgeons that do every rhinoplasty through a closed approach. There are also plenty of lousy surgeons that do open or closed rhinoplasty. What is important is the actual surgeon. I would much rather choose a closed rhinoplasty that was done well to an open rhinoplasty that was done poorly and vice versa. Personally I do both approaches and I tailor each surgery to each patient’s nose and needs. While closed rhinoplasty usually creates less swelling and quicker healing at the tip many patients do require open rhinoplasty for better more structural tip work. Do your homework and choose your surgeon properly.
