What's a better method for a very long, hooked, bulbous, Italian nose; closed or open Rhinoplasty?

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  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 (ENT)  that you trust and are comfortable with.
You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

First and most important is what needs to be done to make your nose more balanced and more to your liking.  At a consultation you can discuss what the problems are and listen to options or recommendations for improvement.  Part of the discussion will be open or closed.  The key is to get a consultation with an experienced board certified plastic surgeon who has an expertise in noses.