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Closed Rhinoplasty- Tip Work?

Is it possible to obtain a narrowing and refining of a bulbous tip with a closed rhinoplasty?

Doctor Answers 10

Tip rhinoplasty

The choice of approach, open or endonasal (closed) depends on the anatomy of your nose and, to a large extent, the surgeon's personal preference.  Yes, you nose can be narrowed through an endonasal approach; just make sure you choose a surgeon who does a lot of endonasal rhinoplasty.

Boston Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

123 Summer Street
Worcester, MA 01608

Closed Rhinoplasty For Bulbous Tip

Dear Jules,


Depending on the symmetry and shape of your nose, open or closed Rhinoplasty is best.


Without physical examination, it is hard to assess your current status.

I encourage you to seek consultations with board certified surgeons who will help you make a well informed decision.


The best of luck to you.

Dr. Sajjadian


Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 176 reviews

496 Old Newport Blvd
Newport Beach, CA 92663

Correction of Bulbous Tip with Closed Rhinoplasty

If the only problem is that the tip is bulbous, this can be corrected with a closed procedure. However, I do recommend an open approach for many other tip problems especially if this is a revision.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

416 N Bedford Dr
Beverly Hills, CA 90210

Tip work through closed rhinoplasty.

Yes the nasal tip can be narrowed and refined through a closed Rhinoplasty approach. Most expert Rhinoplasty surgeons will  perform either open or closed approaches depending on the particular situation, Both have pros and cons. Discuss these with your surgeon so that you are fully informed.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
5.0 out of 5 stars 75 reviews

100-1537 West 8th Avenue
Vancouver, BC V6J 1T5

Open verses closed Rhinoplsty for Bubous tip

I have been using both the techniques for past 30 years and each approach has its indications.If the nose tip feels fatty tissue mainly then perhaps an open rhinoplasty will be simpler for the surgeon to perform and give a better result however if its the thick large bulbous lower Alar cartilage is the cause a closed rhinoplasty will be good take care of it.


Ashok Govila, FRCS, MCh, MS
Dubai Plastic Surgeon
5.0 out of 5 stars 64 reviews

Villa 898
Umm Suqeim 1, Dubai 04

Rhinoplasty Approach for Tip Work

The answer to your question is "It depends".  The "closed rhinoplasty" to which you refer only describes the approach, not what is actually done.  The same techniques to refine the nasal tip are done through both open and closed approaches.  The important determinants as to which is used are the degree of deformity, asymmetry, skin thickness, and experience of the surgeon with one or the other.

In my hands, I will usually recommend an open approach if there is significant tip work to be done.  The scar is almost imperceptible and the exposure provided allows me to be much more precise in my correction. 

James Bartels, MD
Manchester Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

30 Canton Street
Manchester, NH 03103-3540

Closed Rhinoplasty- Tip Work?

 Yes, I have used both Open and Closed Rhinoplasty for over 25 years.  It depends on the shape of the nasal tip as well as the existing tip symmetry and angle of rotation as to which Rhinoplasty technique is best in your particular case.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

8500 Wilshire Blvd
Beverly Hills, CA 90211

Closed rhinoplasty can correct tip asymmetries

Of course before there was open rhinoplasty, closed rhinoplasty was used even for bulbous or asymmetric tips. A good surgeon should be skilled in both open and closed approaches to rhinoplasty. If the columellar scar is not right for you, keep looking for a surgeon who is not uncomfortable with a closed procedure.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 36 reviews

8901 West Golf Road
Des Plaines, IL 60016

Tip work with closed rhinoplasty.

Tip work with closed rhinoplasty can be done if there is relative symmetry of the tip. For t

35 years I have pioneered Open rhinoplasty when there is asymmetry and need for cartilage grafts.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

416 N Bedford Dr
Beverly Hills, CA 90210

Bulbous Tip Reduction through a Closed Rhinoplasty


It depends on whether you have a cartilagenous or  fatty bulbous. If you have large bulbous lower lateral cartilages and thin skin, then a closed rhinoplasty should do the trick. However, if your nasal tip is at all fatty with weak, flismy lower lateral cartilages, then a closed rhinoplasty is not the way to go. An open rhinoplasty for a fatty bulbous tip allows for removal of fatty tissue under the nasal tip and precise placement of cartilage grafts.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
5.0 out of 5 stars 235 reviews

44 East 65th Street
New York, NY 10021

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.