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Open or Closed Rhinoplasty for Nose Shape?

asked 2 years ago by bianca345 in romania
Latest answer by Raffy Karamanoukian, MD
Question viewed 2,967 times
Tags: nose, female, closed, open, technique

I have talked to two top doctors in my country for Rhinoplasty consultations. Doctor 1 proposes we do open plastic surgery; he will make my nostrils smaller, rotate my tip, and basically work only on the cartilage. Doctor 2 wants to do closed Rhinoplasty, work on my bone as well as the cartilage, and not modify my nostrils. My nose is not very big to begin with, it's just that I'm not happy with its shape.Which doctor should I choose? I've added a picture of how I'd like my nose to look after.

20 answers to Open or Closed Rhinoplasty for Nose Shape?

Open Versus Closed Rhinoplasty

The question of which surgical approach to rhinoplasty is the "best" -- Open versus Closed -- is one of the most frequently debated topics among Rhinoplasty Specialists. Unfortunately, there is not a simple answer to this question. However, gaining a better understanding of what is involved with each technique and becoming familiar with the advantages and potential disadvantages of each is the first step. How do you know which approach is "best" for you? While you may... more

C. Spencer Cochran, MD
Dallas Facial Plastic Surgeon

www.rhinoplasty-usa.com

Open Rhinoplasty vs. Closed Rhinoplasty

Proper assessment of your nose should be with pictures of the frontal profile, WEP, and side profile. It seems as though you will definitely require columellar work and tip work and in this detailed case, you would fair better with an open rhinoplasty with tip work.

Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon

Having a experienced surgeon who you trust is what matters

It is important to find a nasal surgeon who you believe in, trust and will give the results that you desire. It does not matter whether the nose is done open or closed; just look for someone who has lots of experience and has done thousands of rhinoplasties. Make sure you research the surgeon quite well as far as his credentials, background, training, experience, and look at plenty of before and after photos.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Which is Better - Open or Closed Rhinoplasty

Dear Bianca, First, I'm glad the picture you posted is of your desired nose rather than your current nose. I looked at the picture before reading the text and I was thinking you had no reason to ask for a rhinoplasty! It would have been more helpful for you to send your current (unmodified) nose, so I would have a better idea of what you are starting with. The discussion of open vs. closed has been going on for years. I perform both techniques, and like to use the closed approach... more

Michael A. Bogdan, MD
Dallas Plastic Surgeon

Depends on how much nasal tip work needs to be done

Over the last 25 years I have used both closed and open techniques. If I'm performing work on the septum, which is the cartilage between the two nostrils, or if I'm just smoothing the dorsal hump or narrowing bones, I will usually perform a closed rhinoplasty. If I'm doing more extensive work on the nasal tip, narrowing it, remodeling it, correcting deformities that require cartilage or bone grafts, I will do an open technique through a small incision in the collumela which is... more

Joseph M. Perlman, MD
Houston Plastic Surgeon

Open vs Closed Rhinoplasty

First and most important you must decide what changes you want. I've used both the open and closed techniques for many years. Which technique is not nearly as important as the the surgeon who does your rhinoplasty. Pick the surgeon, not the method. Look carefully at their experience, their reputation, and their results.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Rhinoplasty

Without examining you and seeing more photos of you in different poses, makes it difficult to answer this question. Open or closed, it depends upon the surgeon, However, I personally perform mostly open rhinoplasties because I feel it can give the most natural and precise result.

Steven Wallach, MD
Manhattan Plastic Surgeon

Open Rhinoplasty allows more accurate nasal tip modification and usually improves results

The best Rhinoplasty surgeons in the world can probaly get equal results with open or closed approach. However, today the open approach is more favored.The open approach allows direct vision of the underlying cartilagenous structure which mean that they can more easily and accurately shaped to the new profile.If what you mainly want is a better shaped tip, I would go with the open approachApril see before and after photos of Rhinoplasty.

Brooke R. Seckel, MD
Boston Plastic Surgeon

Younger surgeons are more comfortable with open rhinoplasty.

Hi! Both rhinoplasty techniques are good. I personally use the open technique only when complicated tip work is necessary. Each surgeon is most comfortable with a particular approach. So pick the surgeon you trust the most (Ask to see a lot of before and after pictures.), and let him or her do the operation they recommend. The surgeon determines the result, not the specific operation. You can probably get a great result with either one.

George J. Beraka, MD
Manhattan Plastic Surgeon

From your pictures you do not need rhinoplasty

There are different ways to achive a good result. In general open rhinoplasty is more predictable that closed. From limited view of your nose ,I would not recommend rhinoplasty. Your nose angle is very high already and if you rotate it any, it will look unnatural. Good luck and do not rush to get surgery(try computer imaging before surgeryto see if you will like the result)

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Open and closed rhinoplasty both work very well

There are many techniques and methods to shape the nose in cosmetic rhinoplasty. Textbooks have been written to describe the various concepts and ideas used by surgeons which have given patients predictable and stable rhinoplasty results. Cosmetic surgeons in the US generally perform both open and closed rhinoplasty procedures and indeed in our practice we perform closed rhinoplasty about one third of the time. Excellent results can be had with either technique. What is most important is... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

Open or Endonasal ("closed") Rhinoplasty

Your final outcome will not depend on the approach (open or endonasal) but on the surgical "moves" employed by your rhinoplasty surgeon. Pros and cons of these techniques are often stressed by each surgeon depending on his own preferences. Pick your surgeon depending on his experience and your comfort. A couple of additional points: Narrowing of the nostrils (a.k.a. alar base reductions) should be performed cautiously because there are virtually irreversible. Although they may be... more

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon

www.drfechner.com

Rhinoplasty; Open Versus Closed Approach

Hi Bianca, Choosing your rhinoplasty surgeon is most important in the ultimate success of your operation. The approach to rhinoplasty whether open or closed should not be a deciding factor. Good luck and enjoy your new nose. Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

The rhinoplasty surgeon is the key

The bottom line is that good results can be achieved with either approach, and it depends more on the surgeon and his judgement than on the approach. Pick your surgeon based on his level of expertise and if you feel he can get you the results you want, but whether he does it open or closed is less important in my opinion. One final note- if your nostrils are to be narrowed, that scar is the same whether you do it open or closed, but those incisions heal very well. Good luck! Dr. Salemy more

Shahram Salemy, MD
Seattle Plastic Surgeon

www.drsalemy.com

Surgeon Expertise is important in Rhinoplasty surgery.

I perform nearly all of my Rhinoplasty surgeries with an open approach; especially if there is tip work involved. It's how I was trained, and this approach allows me to deliver predictable, natural results. Some Rhinoplasty surgeons prefer a closed approach, and get great results so research your doctor carefully. You should go to an experienced Rhinoplasty surgeon, and view many photos of favorable results before proceeding. I hope this helps, and best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

www.ericmjoseph.com

The most comfortable approach is the right approach!

Hello Bianca, I like what you simulated for your nose. Unfortunately, without a picture of what your nose looks like unaltered, it is difficult to make specific recommendations. I perform both open and closed rhinoplasty. When I make a decision for one technique vs. another, it is based on the idea that I can deliver the patient's surgical goals with that particular technique. Each of your surgeons has a different plan for the way to approach your nose, but in the end, hopefully they are... more

Manish H. Shah, MD
Denver Plastic Surgeon

Approach is not the Key to Successful Outcomes

Every good surgeon has a comfort level with one approach or the other based on experience. I have the longest experience of any living surgeon in the US with external Rhinoplasty so my comfort level is with the open approach but others prefer the closed approach and there is nothing wrong with that. On the other hand looking at your pictures at least from the only view provided I am not certain what you hope to accomplish with Rhinoplasty. I would have recommended a chin augmentation... more

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon

Open versus closed rhinoplasty

The question of open versus closed rhinoplasty is even debated among the world's rhinoplasty experts. There is not a correct answer and one answer is the the same for each patient. It all really depends on your anatomy and your surgeon's preference and training for surgery.

David Shafer, MD
New York Plastic Surgeon

Open vs Closed approach to Rhinoplasty

Its immaterial. Open and closed approaches are a personal preference of a physician. For a primary (first time) rhinoplasty either approach is equally good. It is more to do with the competence level of the surgeon than the approach. You should focus more on who is a better surgeon and who do you feel more comfortable with. Regards

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon

Open vs. closed rhinoplasty

Open or closd rhinoplasty describes two types of exposure for the surgery, not what is actually done to change the appearance. Both allow adjustments of all three aesthetic units of the nose-upper 1/3, middle1/3 and the tip. I have been doing rhinoplasties for 30 years and now use the open approach almost exclusively. I have found that asymmetries of anatomy are often discoverd by the open approach that would not have been anticipated by the closed method. In the end, though, the approach... more