Closed Rhinoplasty to Refine Tip After an Open Rhinoplasty?

I have had open Rhinoplasty, but I was wondering if the closed approach is a viable option for just some more tip refinement. My tip seems a tablespoon too wide still. I have heard of some PS's entertaining a closed rhino for the 2nd time around if its done for very minimal changes.

What are your thoughts on this? I also have ear cartilage graft in place and wonder if that is a factor?

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cartilage nose

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3 Doctor Answers | Asked by MsMiami77 in Miami, fl

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Open Versus Closed Rhinoplasty

The question of which surgical approach to rhinoplasty is the "best" -- Open versus Closed -- is one of the most frequently debated topics among Rhinoplasty Specialists. Unfortunately, there is not a simple answer to this question. Each rhinoplasty patient is unique, and therefore each rhinoplasty should be unique. While many plastic surgeons and facial plastic surgeons perform rhinoplasty, very few specialize in secondary (revision) rhinoplasty. Post-rhinoplasty deformities can... more

Revision Rhinoplasty

Nasal tip revsion surgery after prior extensive cartilaginous grafting can be a challange. Minor revisions can often be performed via a closed approach with additional grafting or shaving of scarred cartialge. In my hands, major revsions can be best assessed and corrected with open technique. Often, extensive scarring occurs distorting the underlying cartilage and grafts requiring major restructuring.

Forget the technique--go to a good revision rhinoplasty specialist.

We were 2 of the first 4 surgeons in the US to pioneer open rhinoplasty. Having said that, we see many patients for revision who have been done both ways. The key is to see an experienced revision rhinoplasty surgeon and have him give you the pros and cons of doing the tip open or closed.