What is the best rhinoplasty approach for my nose, open or closed? (Photo)

I spoke to two surgeons. The first one suggested open then he said he can work on my hump and not be able to do any tip work with closed approach but he would do closed. Another doctor suggested open approach. He said most doctors do open. Closed is the old fashion way. He can achieve better results with open. I would like my hump to be shaved down so I have a straight profile with slight tip elavation so my nose doesnt droop down and flare when smiling.

Doctor Answers (14)

Choice between open and closed rhinoplasty

+2
My choice for you would be an open approach.  This approach allows you to carefully and accurately measure, shape and contour the nasal structures during the surgery. You nasal hump would be reduced, your tips projection decreased and the drooping of the nose corrected.  The incision for an open approach is very well hidden after it has healed.  A consultation would allow your plastic surgeon to teach you more about how your nasal contour would be improved.


Boston Plastic Surgeon
5.0 out of 5 stars 32 reviews

Your nose is complex

+2
The best approach is what the surgeon is best at.  I would do your nose open.  Without examining you, of course, it looks like your tip over projects and droops.  The hump reduction is just part of it.  I think you would be best served through an open approach.  Do not worry about the scar.  It generally hides very nicely. I have attached a link about ethnic rhinoplasty.

Stuart H. Bentkover, MD
Boston Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

What is the best rhinoplasty approach for my nose, open or closed?

+2
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. A closed approach is not "old fashioned."  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 (otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California




Robert Singer, MD
La Jolla Plastic Surgeon
4.5 out of 5 stars 14 reviews

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What is the best rhinoplasty approach for my nose, open or closed?

+2
Either method is acceptable. Best to seek a surgeon with excellent befores and afters of each technique of rhinoplasty...

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Closed vs open

+2
I would not worry so much on the type of approach used, just that the surgeon is comfortable with it.  Most surgeons train in one or the other way and usually adopt a preferred method.   You can get a great result with either method. 

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Open vs. closed rhinoplasty

+2
A plastic surgeon skilled at rhinoplasty can perform the procedure either way.  It is usually determined on a case by case basis.  If grafting and sculpting of the tip is going to be more difficult I perfer an open approach.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

Open or Closed Rhinoplasty

+2
The debate between facial plastic surgeons regarding which rhinoplasty method- open or closed- is best has been ongoing for years and will likely continue for many more. In theory, your specific surgical goals could be accomplished via either technique. Rather than focus on exactly which technique your surgeon uses, it is best for you and your surgeon to have an open discussion about your goals so that the two of you can determine realistic expectations of a post-surgical result.

Stephen P. Smith, Jr., MD
Columbus Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Open Vs Closed

+2
This is a question of training and preference. Some surgeons feel better with one approach than the other. I use both approaches but my favorite approach is closed approach. The pros and cons of each approach are discussed and debated by the best surgeons in the world without an agreement. 
In summary, go with the surgeon you are most comfortable with instead of deciding based on the rhinoplasty approach. 
Regards
Dr J

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Open versus closed rhinoplasty for droopy nose

+2
The  only difference between open and closed rhinoplasty is the lack of an  incision across the columella with a closed technique. The internal incisions with open and closed rhinoplasty are identical. Through closed rhinoplasty techniques, the tip can be raised and narrowed, the hump shaved down and osteotomies performed. Releasing the depressor septi ligament could also be performed at the same time through closed rhinoplasty.  Excellent results can be obtained with either approach. For many examples,  please see the link below  to our extensive closed rhinoplasty photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 56 reviews

Well-performed Rhinoplasty Surgery may result in a smaller more feminine nasal appearance.

+2
You appear to have a long nose with a dorsal hump and a droopy nasal tip. In order to address your droopy tip, it would need to be reconstructed, and in our practice, an open approach is preferred.

Hope this helps you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 276 reviews

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.