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More Closed Rhinoplasty Successes Attributable to Doctor's Experience?

asked 2 years ago by Anna Paula in Vienna
Latest answer by Francis R. Palmer, III, MD
Question viewed 675 times
Tags: nose, plastic surgeon, results

I am choosing a plastic surgeon. By seeing the before and after pictures, I have noticed, that doctors who performed more closed rhinoplasty surgeries have offen also better results. Is it because they have normally more experience?

21 answers to More Closed Rhinoplasty Successes Attributable to Doctor's Experience?

Closed vs Open Rhinoplasty

Experience is VERY important in rhinoplasty surgery. However, the technique used does not tell you anything about experience. I have used both approaches for 30 years. Does that make me experienced? Pick the experienced surgeon whose results you like. You are smart to thoroughly explore your alternatives.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Open versus closed Rhinoplasty

The argument over open versus closed rhinoplasty has been going on for several years. One of the best observation one of my colleagues has made is that no matter what level of experience you have, since the open rhinoplasty approach was introduced, surgeons who perform both procedures will tend to favor the open approach when the case is more complex. These cases include nasal valve repair, revision rhinoplasty, and when a great deal of tip work may be necessary. The closed rhinoplasty... more

Philip S. Schoenfeld, MD
Chevy Chase Facial Plastic Surgeon

Rhinoplasty Results and Approach

The aesthetic results after rhinoplasty have very litte to do with approach (open vs. closed) but with the exact planning and execution of the procedure. Excellent results can be obtained in almost every nose with either technique. Exceptions to this rule are complex revision rhinoplasty where extensive grafting (often with the use of rib cartilage) are necessary. But, you will see that certain rhinoplasty surgeons have preferences for one or the other approaches which is a reflection of... more

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon

www.drfechner.com

Open Rhinoplasty is a nasal tip decision

Closed rhinoplasty was the dominant rhinoplasty approach prior to the late 1980's. Therefore, surgeons trained prior to this time are generally more comfortable with endonasal rhinoplasty. The open rhinoplasty approach is used much more commonly these days. That having been said, there aren't many disadvantages to an open rhinoplasty approach (in the hands of a skilled surgeon) except for a very small scar in the columella (skin bridge between nostrils). The advantages include better... more

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon

www.drprendiville.com

Rhinoplasty results may be related to results

Closed rhinoplasty is typically reserved for less complex cases. It is logical that you would get better results in these instances. However open techniques are more commonly employed in more difficult situations where a higher rate of less favorable outcomes is more likely.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Open vs. Closed (Endonasal) Rhinoplasty Results

Closed (endonasal) or open rhinoplasty surgery have their advantages and disadvantages. There isn't a better method or approach that is applicable to all patients. The plastic surgeon can modify or alter any part of the nose, including the tip and hump with either technique. The exact method of rhinoplasty is based on the plastic surgeon's prior training and expertise, and the requirements of your specific rhinoplasty. Some outstanding rhinoplasty surgeons may utilize one approach, either... more

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon

Rhinoplasty, Beverly Hills Rhinoplasty, Nasal Refinement, Nose Job, Closed

I have performed both open and closed Rhinoplasty for over 20 years and it's the training and experience of the plastic and cosmetic surgeon that's the most important, not whether they do an open or closed. Find a Rhinoplasty Surgeon that you feel comfortable in their aesthetic vision and experience and let them decide whether they want to do your Rhinoplasty open or closed.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Results of open rhinoplasty vs closed rhinoplasty

It is important to choose a facial plastic surgeon that has done thousands of rhinoplasties. Look at many of the surgeon’s before-and-after photos. An experienced surgeon who has done thousands of rhinoplasties can obtain excellent results. Whether the procedure is done as an open rhinoplasty or a closed rhinoplasty is the surgeon and patient’s choice and really should not have any bearing or effect on the eventual outcome. The only difference is that on the open rhinoplasty... more

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Results aren't determined by an open or closed approach

When choosing a rhinoplasty surgeon, the MOST important thing is their experience and results. I've seen both fantastic and terrible results from doctors using either open or closed techniques so that does not matter. Doctors are trained a certain way, and that becomes what they are comfortable with, whether open or closed. You should look at the doctors operative experience (doing a rhinoplasty at least every week) and results (a lot of pictures) to decide who will give you a great result.... more

Andrew Miller, MD
Edison Facial Plastic Surgeon

Open Versus Closed Rhinoplasty -- Surgeon's Experience is More Important

One of the most important factors in the success of your rhinoplasty is your surgeon's experience level. The surgical approach is much less important. How do you know which approach is "best" for you? While you may have a preference for one or the other, your surgeon will recommend the approach that he or she feels is most appropriate, and the surgical technique employed depends primarily on the goals established by you and your surgeon. Some surgeons perform exclusively closed... more

C. Spencer Cochran, MD
Dallas Facial Plastic Surgeon

www.rhinoplasty-usa.com

Surgeons who preform closed rhinoplasty often have more experience

Yes, it is true that surgeons who perform closed rhinoplasty often have more experience than those who don't. This is an older technique and is more difficult to teach to new surgeons during their training. For this reason, at many teaching institutions, residents are taught the "open" technique, where the resident can actually see what is being done by the senior surgeon. As a result, many younger plastic surgeons have never learned the "closed" technique, or simply... more

Steven L. Ringler, MD
Grand Rapids Plastic Surgeon

Closed rhinoplasty surgeons are generally older...

and therefore may have more experience just on the basis of their number of years in practice. As mentioned by another respondent, the open approach didn't come into favor until the late 80's or even early 90's. Of course, there is no scientific evidence to show who gets better results, open or closed. Good luck

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

What's better Open vs Closed Rhinoplasty

The short answer is both approaches are good and in the hands of a skilled and experienced rhinoplasty surgeon, the results should be equal. Having said that, in my practice, I perform about 60% open and 40% closed. My criteria is based on how much work needs to be done on the tip. If significant modification is required then we do it as an open approach. This is simply based on exposure that it takes to build good structure and stable modification of the cartilaginous framework. Web... more

Amir M. Karam, MD
San Diego Facial Plastic Surgeon

www.drkaram.com

Totally Disagree with this hypothesis

I would vigorously challenge the idea that those who do closed Rhinoplasty have better results. I have now done almost 2000 Open Rhinoplasties over the past 27 years. Please look at the pictures on our website as I believe that they compare favorably with anyone doing primarily closed Rhinoplasty. Historically I trained with the physician who is generally given credit in this country for popularizing the open rhinoplasty. Dr Anderson did 10,000 closed rhinoplaasties prior to 1981 but... more

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon

Rhinoplasty Success, Dependent on Closed or Open Approach?

Hi Anna, The simple answer to your question is no. Open or closed is just an approach to rhinoplasty. What determines the results is the rhinoplasty surgeon's skill, experience, attention to detail, and aesthetic sense of beauty and proportions. Do choose your rhinoplasty surgeon carefully. Good luck and be well. Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Closed versus open

Closed vs. open rhinoplasty is dependent on visualization needed to change the structures of the nose and the difficulty of the changes being made. Some surgeons feel very at ease with the closed approach for most of their cases, while others use the open approach because of the need to directly visualize the structures. Another issue is that teaching and learning the closed approach is more difficult. Thus, some older surgeons don't rely as much on the open approach. One caveat is that... more

Ricardo Izquierdo, MD
Chicago Plastic Surgeon

www.FaceAndBodyChicago.com

Closed versus open rhinoplasty

Choose a surgeon based upon the quality of his results. Open or closed doesn't matter. My preference is open because I think there is more control and therefore more consistency in delivering great results.

Steven Wallach, MD
Manhattan Plastic Surgeon

Natural Rhinoplasty results are what counts

Interesting observation. You have discovered one of the truths of cosmetic nasal surgery: experience counts. The operation is the most technically challenging in all the world of cosmetic surgery. Superior training, experience and an " aesthetic sense" (inherent sense of what looks right) are the hallmarks of the most accomplished cosmetic nasal surgeons. What technique the surgeon uses should not be a criterion for doctor selection. For all cosmetic procedures, it's only about... more

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon

Open vs Closed

I would not choose your surgeon on the basis of if they do closed or open. Each technique has it advantages and disadvantages. The technique chosen should be based on your anatomy and what needs to be addressed. There are some things that open rhinoplasty is better for, and it does not matter how much experience the surgeon has doing the closed. You just need to choose your surgeon carefully but not solely based on the if they do open or closed.

Farbod Esmailian, MD
Orange County Plastic Surgeon

Open versus closed rhinoplasty

Your observation is a good one, but don't choose your plastic surgeon solely based on the before and after photos. Rhinoplasty can be done open or closed, as you know, but when a significant amount of work needs to be done open rhinoplasty may be a better choice. Yet, if you are comfortable with your surgeon, you like his/her results (closed or open rhinoplasty), and you know what results you are looking for then you're ready!

Jeffrey E. Schreiber, MD
Baltimore Plastic Surgeon

What is the best approach for Rhinoplasty?

I think that you may have noticed better results with closed rhinoplasties because of a selection bias. Closed rhinoplasty is often chosen for more simple noses. The open approach is more often used in cases where there is assymetry or in cases of revision rhonoplasties. Having said that, I aggree that as surgeons become more experienced, they may tackle more nose jobs through a closed approach. Certainly, more experienced surgeons have better surgical outcomes. Good luck in your pursuit... more