Am I candidate for closed rhinoplasty? (Photo)

Question

Looking to get a rhinoplasty soon and exploring into open vs. closed rhinoplasty. I like the idea of closed but I don’t know if my nose is too complicated for that. I love the idea of natural subtle changes. I still want a somewhat bigger nose that still looks like my nose because a small swooped nose would not fit my face. Cant wait for some responses! Thank you.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  You appear to have a bulbous nasal tip, dorsal hump, and over projecting tip.   Based on your photographs, you may benefit from a tip refining rhinoplasty, a cephalic rotation of your tip to turn up your tip slightly, and a conservative dorsal hump reduction.  The most important and complex aspect of your surgery will be a nasal tip deprojection to make your nose appear less elongated.  Nasal tip deprojection requires open rhinoplasty for the best result in my opinion.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon.  If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon. 
 
 Best wishes and good luck.

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Vito C. Quatela, MD · Answer

Thanks for your question. It’s a bit tough to answer because it really is highly dependent on your surgeon. Some prefer the closed technique while others always prefer the open technique. I think the short answer is yes, you could have a closed rhinoplasty with the right surgeon. In primary cases, a closed rhinoplasty can be a good option if you have the right surgeon and expectations. Best of luck.

Deepak Raj Dugar, MD · Answer

Hello!
Thank you for your picture and question!Based on the pictures you have submitted It does appear that you would be a great candidate for a Closed Scarless Rhinoplasty. A closed rhinoplasty procedure is the best option for someone who is looking for a refinement of the nose. I recommend going to a Plastic Surgeon that specializes in closed scarless rhinoplasty (preferred by actresses and celebrities) because there is no risk of external scarring and much less healing and recovery time. Closed rhinoplasty enables you to have flash recovery with very minimal bruising if at all. You will only have to wear a cast for 5-7 days, no one will know you had anything done. All the incisions are made from inside the nose. The goal is to finesse and enhance the nose without drastic change. It still looks like it is your nose just more refined without looking fake. Meaningful refinement is the key!  All the same surgical maneuvers your nose requires can be performed with a skilled closed scarless surgeon. 
Best of luck, 
Deepak Dugar MD
Beverly Hills Rhinoplasty Center

Suleyman Tas, MD, FEBOPRAS · Answer

Hi,
Thank you for sharing photos, with Closed Rhinoplasty you will not have a scar in your columella,
incisions are hidden inside your nose and a-state-of-art Closed technique operation your healing is maximal, and with atraumatic technique your tissue damage will be minimal.
Regards

Luis A. Mejia, MD · Answer

hello thank you for your question and provided information as well... based in your question and the picture you showed you are a good candidate for rhinoplasty , in your case with technique open and elevate the tip.

Roger Tsai, MD · Answer

Great question! Your procedure could be performed in a closed or "scarless" fashion. It is important to maintain your same overall general appearance and would not want to have a drastic change to your nose - we want to keep it natural and looking like you still. Removing the small hump on your bridge as well as narrowing the bridge and the nasal tip will provide you with a more refined nose that will maintain your appearance. Best of luck and hope this information helps!

- Dr. Roger Tsai @DrRogerTsai
Board Certified Plastic Surgeon

- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon

Ronald J. Edelson, MD · Answer

You are certainly a good candidate for a rhinoplasty either open or closed.  Most surgeons do their noses one way or the other regardless of what is needed.  Fewer and fewer surgeons are taught how to do a closed rhinoplasty.  I would concentrate on selecting an experienced surgeon who can show you many cases and with whom you feel comfortable.  Might need to see a few different surgeons before you find the one that feels right.

Steven M. Denenberg, MD · Answer

Your nose has a strong bump on the bridge, so we would want to remove that. But also, the tip of your nose is very strong in its forward projection away from your face. That feature is somewhat hidden by the strong hump. When the hump is removed, the projection will seem even bigger. So, if ONLY the hump is removed, your nose will actually look worse after surgery!
So the tip of the nose needs to be brought closer to your face. The woman in the short video that I posted with this answer had the tip of her nose brought closer to her face.
But when the tip of the nose is brought closer, your nose will LOOK longer, as if the tip had drooped. So the tip needs to be elevated. 
Then, going back to the bump, after removing the bump, the top of your nose, just below your eyebrows, needs to be addressed. That part needs to be reduced, too, or your profile will take on some of the characteristics of a Roman statue, where the profile line slides from your forehead right down onto the nose, without a little dip between forehead and nose. You wouldn't like that, either.
These changes can all be made, keeping your nose natural and attractive looking. But your surgeon must understand the concepts completely.
And it's not the open vs closed that will determine that; it's the skill of the surgeon.
Rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes I described above require advanced techniques, requiring skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. 
Your nose is also a perfect example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?! 
But remember, you're not the surgeon for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.
In your case in particular, you need to find a surgeon who has the technical skills to handle *all* of the issues I described above.

Thomas Trevisani, MD · Answer

Based on your photos- you appear to be a good candidate for Rhinoplasty- preferably performed through a closed technique. In the right-expreinced hands-- you can expect a very pleasing, feminine and natural looking nose. I suggest that you seek an experienced Board Certified PS with extensive Rhinoplasty experience - for in person exam

David Shifrin, MD · Answer

Closed is good for work on the hump. It allows limited access to the nose in exchange for avoiding the small incision on the collumella. Rhinoplasty is a game of millimeters and having all the advantages is better in my opinion. Best