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Should I Have an Open or Closed Rhinoplasty?

What's the difference between an open rhinoplasty and a closed rhinoplasty? Should I choose a surgeon who uses one rhinoplasty technique over the other?

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closed open technique

Choose your surgeon by his results, not the technique

This is a question that is still a ‘hot button’ issue among surgeons who have very strong feelings one way or the other. But, the debate thankfully is not quite as big a deal today as it was once was. When rhinoplasty first became very popular in the last century, all of the work was done through the nostrils from the inside. The surgeon tunneled under the skin over the bridge of the nose and made alterations almost blindly. This is called a closed rhinoplasty because all of the... more

Jason Litner, MD

Beverly Hills Facial Plastic Surgeon

Open (external) versus closed (endonasal) rhinoplasty

Let me begin by saying that I perform both open and closed rhinoplasty so there's no bias on my part towards one approach or the other. As you have heard from other surgeons on this post, the only significant difference between the two approaches is a tiny incision on the columella, between the nostrils. This incision heals nearly invisibly if created and sutured carefully. The healing of this incision has never been an issue for any of my patients. My personal preference is to... more

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Umang Mehta, MD

Bay Area Facial Plastic Surgeon

Open and closed rhinoplasty can reshape the nose

An "Open" Rhinoplasty refers to a technique where a small incision is made at the bottom of the nose (the columella). "Closed" rhinoplasty involves all incisions inside the nose with no external scar. An experienced rhinoplasty surgeon can use either technique. The choice should be based on what is the most appropriate method to achieve the results desired.

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Robert Mounsey, MD

Toronto Facial Plastic Surgeon

Open vs closed rhinoplasty

An open rhinoplasty requires a small scar on the columella ( skin between the openings of the nose ). I would focus on the experience of the surgeon rather than the technique utilized. All the techniques are straightforward what varies is the experience and skill of the individual providing the surgery.

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Jay M. Pensler, MD

Chicago Plastic Surgeon

ASAPS ASPS

Open vs closed rhinoplasty

The simple difference that you might notice is a small scar on the columella of the nose. However, this incision usually heals with a barely perceptible scar. Furthermore, open rhinoplasty in my opinion gives more control and better visualization of the underlying nasal architecture to give a better result in most cases..

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

VIDEO (Click below) Open versus Closed Rhinoplasty: the ongoing debate

In deciding open versus clsoed rhinoplasty, there is no "one size fits all" approach. In some instances, simple corrections are easily achieved with a closed approach and an open technique would be overkill with prolonged recovery. However, in more complex cases such as revision rhinoplasty there is no substitute for an open approach where complete exposure facilitates visualization for accurate placement of grafts. However, even some experts believe... more

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

Open rhinoplasty vs. closed depends on the surgeon.

I began doing all my noses closed but over time now do nearly all of them open. I first used the open technique on cleft lip and palate noses. Later I found that often times there are asymmetries in outwardly appearing symmetrical noses that can be unmasked with a blind closed rhinoplasty. I think it takes longer for the tip swelling to subside with an open approach. I do not think the scar is an issue.

Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon

ASAPS ASPS

Open vs Closed rhinoplasty should not be the deciding factor

An open rhinoplasty is performed with an incision across the columella. The advantage of this technique is better visualization of the cartilage (since the skin and soft tissues are dissected off the cartilage leaving everything is exposed). This technique allows surgical changes to the underlying skeleton to be seen directly. The disadvantage is that the extra dissection leads to weakening of the intrinsic support mechanisms of the nose. This means that the nose has more... more

Lawrence Tong, MD

Toronto Plastic Surgeon

ASAPS ASPS

Open Vs. Closed Rhinoplasty

Both of these techniques have their pro's and con's. Open Rhinoplasty is a better technique for correcting previous surgical problems or severe deformities. On the other hand, you may end up with a permanent visible scar. Closed Rhinoplasty leaves no external scars and is an ideal technique for the average rhinoplasty patient. Ultimately, it is up to you and your surgeon to make the decision as to which technique is best for you in achieving the results you... more

Ivan Thomas, MD

Los Angeles Plastic Surgeon

ASPS

Open vs. Closed Rhinoplasty

Open Rhinoplasty offers the surgeon more direct visualization of the structural anatomy of the nose, but there is more prolonged swelling of the nasal tip. There are equally expert surgeons who will choose one technique over the other. There is not one right answer: it is a matter of an expert's judgment and preference.

Paul C. Zwiebel, MD

Denver Plastic Surgeon

ASAPS ASPS

Open and closed rhinoplasty are two different techniques-neither is right or wrong!

Open and closed rhinoplasty are two different techniques to perform rhinoplasty. Shy away from surgeons that tell you only one is right and the other is wrong. Older surgeons sometimes despised open rhinoplasty because it made one incision on the outside portion of the columella. This one incision ALWAYS heals without problems if designed and closed correctly so it is completely a non-issue. In my hands, I perform closed rhinoplasty for simple things like improving... more

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Raghu Athre, MD

Houston Facial Plastic Surgeon

Closed or open rhinoplasty

It doesn't matter ! You should choose a doctor that you are comfortable with and has demonstrated to you that he is an experienced rhinoplasty surgeon. He will, in his hands, perform the surgery using the technique that he thinks will give you the best result.

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Andres Bustillo, MD

Miami Facial Plastic Surgeon

Open or closed rhinoplasty: Let your surgeon decide.

The reason I say this is that the big difference between the two is a small incision on the underside of the nose (on the part called the columella). If done properly, this incision heals very well and is well-camouflaged. This should NOT dictate the approach. The approach should be dictated by the type of improvements the patient desires. If no nasal tip work is needed, a closed approach can give a satisfying result. The closed approach can also be better for some revision work... more

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Anand D. Patel, MD

Austin Facial Plastic Surgeon

Open or closed rhinoplasty approach

There is no one 'correct' rhinoplasty approach as either has a role depending on what your surgeon is trying to achieve. Also, some surgeons have extensive experience with one approach vs the other and solely use the approach that is their preference. Those surgeons, myself included, that focus on ensuring nasal stability via a structural enhancing approach (typically using cartilage grafts) tend to prefer the open approach overall. The very small staggered incision across the... more

Thomas A Lamperti, MD

Seattle Facial Plastic Surgeon

Open or Closed Rhinoplasty?

It is important to understand that the terms "open" or "closed' only define the surgical approach. They are both designed to accomplish the same thing with the only difference being a small incision across the lower nasal bridge (columella). The decision about what approach to use is based on how much nasal tip work is required. If the case requires more sophisticated maneuvers and/or if the case is a revision Rhinoplasty, I will use the open approach... more

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Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

Choosing the best rhinoplasty surgeon

An experienced rhinoplasty surgeon will perform both of these procedures comfortably. The choice depends on what we would like to acheive with your surgery. Meticulous repositioning of cartilage in the tip requires an open rhinoplasty, in my opinion.

Raffy Karamanoukian, MD

Los Angeles Plastic Surgeon

Open vs. Closed rhinoplasty

A good rhinoplasty surgeon should be proficient in both endonasal ("closed") and external ("open") approaches. The needs of the patient, cosmetic desires, and functional issues, among other things, can influence the decision to perform one technique over another. The "debate" over the two approaches has been exaggerated in the media and on the Internet. Both techniques, if done properly on the correct patient, can produce excellent results. more

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Matthew Bridges, MD

Richmond Facial Plastic Surgeon

Both Open and Closed Rhinoplasty can yield excellent results, Trust Your Face to a Facial Plastic Surgeon

Both open and closed rhinoplasty can yield excellent results. You need to be evaluated by a surgeon who is comfortable with both techniques. Open rhinoplasty is often advocated for individuals with severe deformities, while closed rhinoplasty is generally reserved for less severe deformitities. Visit with multiple surgeons who are board certified by The American Board of Facial Plastic and Reconstructive Surgery, The American Board of Cosmetic Surgery, or The American Board... more

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Gregory Pippin, MD

New Orleans Facial Plastic Surgeon

Is open better than closed rhinoplasty?

The history behind the two techniques is the following; the closed approach is the classic and traditional way of performing rhinoplasty. In the early 1070's Dr Goodman from Toronto introduced the open approach to North America. Slowly it has become the accepted. It gives the best possible exposure to the underlying structures of the nose. If you can see what you are doing you have a better chance of doing the best result. It comes at a cost, which is the scar under your nose. Most of... more

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Oakley Smith, MD

Toronto Facial Plastic Surgeon

Closed Endonasal Rhinoplasty vs. Open External Rhinoplasty

The “closed” or endonasal rhinoplasty is the classic way of performing this surgery, while the “open” or external rhinoplasty has been the technique of choice (including mine) for the past 20 or so years particularly amongst surgeons in practice less than 20 years and/or those who perform a lot of revision procedures. My personal reasons for preferring the external approach is the improved visualization and the fact it maintains more tip support mechanisms and... more

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Jeffrey S. Epstein, MD

Miami Facial Plastic Surgeon

Open vs. closed rhinoplasty

An experienced, Board Certified Plastic Surgeon familiar with both Open and Closed Rhinoplasty can address your concerns. All incisions are located on the inside of the nose on closed rhinoplasties. Open rhinoplasty involves an incision at the base of the columella and possibly in the crease of both nostrils. An experienced surgeon can advise you which technique will best achieve the results you desire.

Malcolm A. Lesavoy, MD

Encino Plastic Surgeon

ASAPS ASPS

Open vs Closed Rhinoplasty

In a closed rhinoplasty all incisions are made within the nose. With the open procedure an additional incision is made in the columella (the vertical structure between your nostrils at the base of the nose). Most surgeons use both tecniques, choosing their approach based on their personal experience and the needs of each individual patient. After 35 years, I prefer the open rhinoplasty for revision surgery and noses that require augmentation. However, pick a surgeon based on results,... more

Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon

Open versus closed rhinoplasty

Rhinoplasty is a popular and effective surgery to recontour the shape of your nose. An open rhinoplasty is performed when the skin of your nose is lifted off of the internal cartilage and bone framework. This provides the surgeon with excellent visualization of your structures and can help them create a consistent and beautiful result. A close rhinoplasty does not involve lifting the skin off of the internal framework. Because of the better visualization with an open rhinoplasty technique,... more

B. Pat Pazmino, MD

Miami Plastic Surgeon

ASAPS ASPS

Open or closed rhinoplasty

Both open and closed approaches are commonly used. There are advantages and disadvantages to each. The additional scar from an open approach is virtually invisible in just a few weeks. You should choose an experienced surgeon who you feel comfortable with and whose results are similar to what you want to achieve. Let the surgeon decide which approach is best. You wouldn't tell an artist how to paint your portrait, so don't expect to tell a surgeon how to do... more

Randy J. Buckspan, MD

Austin Plastic Surgeon

ASPS

Which type of noses surgery is better?

You should pick a surgeon that feels comfortable using BOTH techniques. If your surgeon is able to use both techniques you will get the best of all worlds. The open technique differs from the closed or endo-nasal technique by a small incision that is made in the columella (the area between your nostrils). I use the open technique for patients who have very thick skin, need a lot of tip work or have a revision(redo) nose to do. As always ask a lot of questions and see before and after... more

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