Rhinoplasties are usually done with an "open" or "closed' technique. The difference is where the incisions are made. With the closed technique, all incisions are hidden inside the nose.

With an open approach, there is an incision on the bottom portion of the nose, but it usually heals exceptionally well and therefore is almost invisible. 

Some patients are better treated with one approach vs. the other, depending on what is needed to be done at surgery.

Talk to your doctor about both approaches and good luck!

There are two basic surgical approaches to rhinoplasty -- open versus closed. The open technique involves peeling most of the skin off the top of the nose. This allows excellent  exposure of all the bone and cartilage for surgical correction. It requires, however, a small incision across the columella -- the small skin strut between the right and left nostrils. The open rhinoplasty is the best approach for complicated nose operations, for revisions of previous surgery, and for congenital nasal deformities.

The closed technique approaches the nose through separate incisions inside each nostril. The approach avoids the incision across the columella. Manipulation of the anatomy is partially a "blind" maneuver, however, as exposure is compromised. This technique works well for simpler and more straightforward nose operations.

After many years of doing rhinoplasties, I've chosen to use the open approach on most cases. In my opinion, the technique gives the most predictable and reproducible results. I have found that asymmetries are encountered, and dealt with, that would not be recognized in a closed rhinoplasty.

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Scars are scars and are premanent....That having been said, in the hands of an experienced rhinoplasty surgeon, whether OPEN or CLOSED, these scars should melt away and be virtually impossible to detect.

This is a great operation for the right patient in the right hands....search carefully, solicit many professional opinions and I am sure you will be very happy!

Good Luck

Dr. C

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