What is really important is which approach your surgeon thinks will give you his/her best result. I prefer the open approach in most cases. I think that breathing issues and asymmetries in cartilages are best handled in my hands by seeing everything. Grafts are generally more accurately placed through this approach. The swelling persists a bit longer. It is really a matter of surgeon preference, expertise and comfort with the approach. I have attached a link.
It depends what needs to be done. Making tip smaller and thinner can can be done closed. Wide voluminous tips are often done open because of the amount of reduction. From your photo, it looks like you need rotation of your tip and that can be performed through a closed approach.
Choosing between an open or closed procedure really depends on the complexity of the surgery and what needs to be performed in order to achieve the best possible result. An open procedure is necessary for some of the more difficult cases. I would recommend establishing great communication with your surgeon, as this will help ensure that your needs are met and he/she is taking the optimal approach for you. I hope this helps, and I wish you the best of luck.
I still do closed rhinoplasty. I have never had a patient mention the line after open rhinoplasty since this is the easiest part of the surgery. If your surgeon cannot make the incision not show go to a different surgeon.
For your nose-- choose a surgeon whose work looks good and natural and let him decide on which technique!
It is an option. There is NO right answer for you. Some of us (the older PSs) do closed and open rhinoplasties while the younger docs offer open rhino...
In almost every circumstance I will perform a closed rhinoplasty to eliminate the visible scarring, preserve intrinsic support, and reduce the time to swelling resolution. I can get just as nice a result with a closed rhinoplasty, but this will vary surgeon to surgeon.
Kenneth Hughes, MD
Los Angeles, CA
Rhinoplasty is operator dependent. Either approach in good hands will deliver great results.
Each team argues that their approach will deliver a better outcome based on their experience and comfort level. I feel that open technique is safer and more predictable in my hands.
The choice of which approach to use is dependent upon the surgeon, the complexity of the specific rhinoplasty and the predictability of the results. I perform both but I use the open approach most of the time because it allows me to "see" the anatomy better. This allows me to make the necessary changes with better precision and deliver more predictable results. Each approach has its advantages and disadvantages. My best advise is to choose a rhinoplasty surgeon with results that you like and then go with his/her recommendations. Try not to micr manage your surgery. Good luck.
Excellent cosmetic results can be achieved
with both techniques. There is not a best way to perform the procedure.
Individual surgeons have their own preferences of how to produce the best
results in their hands. What is more important than whether a closed or open
approach is utilized is the experience and artistry of the plastic surgeon and
your comfort level and confidence in that individual.
Following the advice from a surgeon on
this or any other website who proposes to tell you exactly what to do based on
limited 2 dimensional photos without examining you, physically feeling the
tissue, assessing your desired outcome, taking a full medical history, and
discussing the pros and cons of the operative procedure would not be in your
best interest. I would suggest you find a plastic surgeon with extensive nasal
surgery experience who is certified by the American Board of Plastic Surgery
and ideally a member of the American Society for Aesthetic Plastic Surgery
(ASAPS) or a facial plastic surgeon that you trust and are comfortable with.
You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California
Performing them open or closed depends upon surgeon preference and goals of surgery. I prefer in most cases to perform them open because I feel I have better control and visualization.