Tip refinement and dorsal hump reduction can be
done in closed fashion so that you do not have any visible scars.
Find a plastic surgeon who performs hundreds of rhinoplasties, has great reviews, and has great before and after pictures.
Kenneth Hughes, MD
Los Angeles, CA
As an experienced rhinoplastic surgeon, I do most noses closed. It avoids a scar and heals faster than an open rhinoplasty.
The correction of most nasal tip issues, including a bulbous tip is the same whether a surgeon uses an open or closed approach. I use mostly closed for 99% of cases but do open on occasion. There's no difference in how the surgery should be done with one approach or the other.
Choose the surgeon, not the approach that best suits your goals.
All the best
The photos you posted is blurry, but if you have a bulbous tip then certainly a rhinoplasty is an option, andI prefer to do them open for more accurate visualization of the structures.
For most of my primary rhinoplasties, I prefer the intranasal or closed, approach. No external incisions are made to narrow the tip. For a very crooked nose or revision surgery, an open approach is often used. Many very skilled surgeons use the open approach for all their rhinoplasties. It's more about the skill of the surgeon instead of a tiny incision that yields a more aesthetically pleasing result.
Whether a nose is done open or closed is more a preference of the individual surgeon, though each would argue that his way is the best way to approach the nose. I do mine closed because I do not like the scar across the columella and do not feel that doing the nose open improves results. Tha said I am certain that there are other surgeons who would disagree with me.
The bulbous tip can be refined through either closed or open techniques. Neither technique is better than the other, some surgeons prefer open techniques while other surgeons prefer closed techniques.