Open or Closed Rhinoplasty? Doctor Answers, Tips
Rhinoplasty: Q&A
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Open or Closed Rhinoplasty?

I went to a consultation with Dr. Graper in Charlotte, NC and he did some imaging on the computer to let me see how my nose should look once the procedure is done. I'd like to get some feedback, should this be an open or closed Rhinoplasty? Thank you!

15 Doctor Answers | Asked by adammullins447 in Charlotte, NC, USA
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Rhinoplasty Surgery: Open vs. Closed Rhinoplasty

How do you know which approach is "best" for you? While you may have a preference for one or the other, your surgeon will recommend the approach that he or she feels is most appropriate, and the surgical technique employed depends primarily on the goals established by you and your surgeon. Some surgeons perform exclusively closed rhinoplasty while others prefer open rhinoplasty. There are surgeons who perform both types of rhinoplasty depending on the patient's needs. Trust your... more
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Open or closed--the surgeon is the key to a good result

First of all, forget the imaging. Look at the kind of long-term results he's had with other patients--real people not computer patients. We pioneered the open technique more than thirty years ago. It gives the surgeon an excellent ability to see what he's doing. However, really good nasal surgeons can achieve good results with either method. More importantly, they know when to use each!
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Open Versus Closed Rhinoplasty...It's Not the Approach, It's Who Is Doing the "Approaching"

Hi Adam, From the picture and computer image it is difficult to answer what is the best approach to your rhinoplasty. After examining the nose, diagnosing what is causing the areas of complaint, and making a plan to correct those complaints, the approach be it open (external) or closed (internal) can better be chosen. In general, if your tip needs increased support, or upward rotation, or a great deal of work, then I prefer the open approach. Otherwise I perform a closed approach... more

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+2

It does not matter

The pictures look like a reasonable expectation from rhinoplasty. The success of the surgery depends more on the experience and skill of the physician than the choice of open vs. closed. Both procedures work well to reduce a dorsal hump. I prefer the open approach because I can see the entire anatomy, but there are plenty of surgeons who perform only closed procedures with great success. Make sure the surgeon does perform rhinoplasty often as this is a procedure that requires knowledge,... more
+1

Open vs. closed rhinoplasty

Thank you for your photos. It looks like your should be able to get a good result. The important thing is the surgeon that is doing the procedure. He/she may have a certain approach that works for them in a given situation. Interview a few of them. Look at the before/after photos. Feel free to discuss the approach with the surgeon.
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Closed rhinoplasty

You need to ask your surgeon what technique he or she is comfortable performing. Surgeon's experience is more important than the technique used. My preference is the closed approach especially for primary (first time) rhinoplasty patients.
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Open or closed rhinoplasty

It can be done either way, open or closed. Nowadays, most plastic surgeons have their own personal preference, based on their experience and training. I prefer the closed rhinoplasty for almost all cases. In my opinion, it is simpler, takes less time and involves less swelling. Unfortunately, many surgeons are taught only one way to do rhinoplasty. If they are trained in open rhino, they only know one way to do it, and will tell you it is the best way to go.... more
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Open or closed rhinoplasty?

The result that you wish to obtain not necessarily based on whether you choose a surgeon who prefers an open or a closed technique. More importantly, is based on the following: There are many competent surgeons who routinely perform either open or closed rhinoplasty is, or a combination of the dose. In my practice, approximate 70% of the rhinoplasty that I do are performed closed, and the 30% are performed open. More importantly, your surgeon should communicate with you what needs to be... more
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Open vs. Closed Rhinoplasty

The choice of doing an open or closed rhinoplasty is really up to the experience and expertise of the surgeon. My preference is to do an open rhinoplasty as one can visualize the deformity and correct it without the use of palpable or visible grafts such as tip grafts. I find that to be a much more anatomic operative procedure. There are many rhinoplasty surgeons who are experienced in closed rhinoplasty that give superb results. The result is what really matters and this is in the hands of... more
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Rhinoplasty techniques

Rhinoplasty, also known as nose surgery, is a procedure that sculptures the nose, changing its shape and/or size. It can be performed to meet cosmetic goals or for reconstructive purposes such as birth defects or breathing problems. Small changes in the nose can often have a significant, noticeable impact on your overall appearance. Therefore, we will work closely with you to learn how you would like the nose to look, to evaluate the structure of your nose and face, and to explain the... more
+1

The surgeon, not the approach, is the important determinant

Having performed many open and closed rhinoplasty surgeries, I agreee that the visualization is much better with the open technique. Having said this, excellent results can be obtained with the closed technique with a surgeon that is experienced and comfortable using that approach. There are certain advantages and disadvantages with each approach and your surgeon will be able to discuss these during a detailed conversation. Properly performed, the open approach rarely results in a... more
+1

Open Rhinoplasty best for a lot of tip work

I am not a big fan of computer morphing because I think that it becomes an implied contract to the patient. It is almost impossible to get the same exact result as the morphed image. Without seeing your other views, it is difficult to see what you need besides the dorsal reduction and some modified tip work. I personally think open Rhinoplasty will more than likely give you the best result. It provides clear visualization of all the underlying structures, and allows precise treatment. It... more
+1

Don't cut your nose ...?

Adam, Presumably you had a full consultation with the surgeon and discussed ALL of the aspects of your nose that you would like to have addressed. If your only concern is the hump, then you would do just as well with a closed approach and avoid an incision on your columella. The open approach is great for tip work and revisions because the tip anatomy can be visualized well and revisions may present scar tissue and anatomical distortions. It is not as critical to visualize the dorsal... more
+1

Open vs. Closed Rhinoplasty a matter of choice

The technique used to perform a rhinoplasty or more simply the operative approach is only a minor consideration. Most plastic surgeons are competent with both techniques, open and closed. For myself, if there is a good deal of tip modification that must be done, I prefer the open approach. Just like everything in plastic surgery there are no absolutes. Your plastic surgeon should explain the differences between the two techniques and pick the most appropriate one for your anatomy.... more
+1

Dorsal Hump = closed rhinoplasty

Open rhinoplasty is great for tip tightening, mid-vault corrections and all revision surgeries. Closed rhinoplasty is good for everything else.
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