Open or closed rhinoplasty? (Photo)

I've been insecure about my nose since I was about 10- when it finally began to take its real shape. Even family jokes about "the hump" not knowing it really hurts me inside.. I'm not so much worried about it being "big", more about the "bump" (if that makes sense). Now that I'm 21 I'm interested in fixing this burden to be happy & confident the rest of my life. Do you think open or closed would be required in my case ?

Doctor Answers 8

Open or Closed Rhinoplasty?

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Based on these pictures your nose could be done using either the open or closed approach but that is not important. As I've said for many years, pick the surgeon not the technique. Having said that, I would probably do a close rhinoplasty on a nose like yours.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

What type of rhinoplasty is best?

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Hi there, this is a difficult problem and depends on your surgeon and the issue you want to solve. My advice, talk to a few surgeons and see what they recommend. For me, if its just a bump, i often do a closed rhinoplasty. If I need to do more advanced tip-work, i do it open. That is just a general guide. 

Dr Bonaparte

James Bonaparte, MD, MSc, FRCSC
Ottawa Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews

Open or closed technique

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I only do closed technique. There are surgeons who only do open technique. And some do both.
Pick the surgeon you are comfortable with and whose post op results you like. Let the surgeon chose the technique.

Dennis Barek, MD (retired)
Great Neck Plastic Surgeon

Closed rhinoplasty approach for dorsal hump reduction the

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A closed rhinoplasty approach can accomplish shaving down the dorsal hump, narrowing the bridge and adjusting the tip with all of the incisions placed on the inside of the nose. No external incision is necessary. Osteotomies of the nasal bones will be required after the dorsal hump removal has been performed. Rhinoplasty is a very difficult endeavor, so choose your surgeon very wisely based on extensive experience.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews


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Hello and thank you for your question. Based on your photograph, you may benefit from a conservative dorsal hump reduction. Your case could be performed with either open or closed technique, depending on what your surgeon prefers.  The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 173 reviews

Open or closed rhinoplasty?

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The difference between an open rhinoplasty and a closed approach is the external scar across the columella with an open approach which is unnecessary with a closed approach. Excellent cosmetic results can be achieved with both techniques. There is not a best way to perform the procedure. Individual surgeons have their own preferences of how to produce the best results in their hands. What is more important than whether a closed or open approach is utilized is the experience and artistry of the plastic surgeon and your comfort level and confidence in that individual.

Following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do and how to do it based on limited 2 dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the operative procedure would not be in your best interest. I would suggest you find a plastic surgeon with extensive nasal surgery experience who is certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon (optolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla,California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

Open vs closed rhinoplasty

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This is completely surgeon dependent. The choice comes down to the type of changes requested by the patient, combined with the surgeons experience and training. Personally, for simple dorsal reduction, I think a closed approach is reasonable. Cases that require extensive grafting to improve the airway, for example, I prefer to do open. 

Bottom line is that the columellar scar from the open approach is often invisible so there is really no wrong way to do it, simply preference. 

Good luck! 

Justin Cohen, MD
Washington DC Otolaryngologist

Open vs closed rhinoplasty

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This is a great question with a somewhat complicated answer.  The short answer is that the best approach to the nose is the one your surgeon feels confident in the ability to perform the needed maneuvers.  Generally speaking bigger, more complex cases are better served by open approach and small cases (ie filing down of a small hump) can be done through endonasal approach.  This is a large oversimplification as some surgeons prefer to do almost all cases with one approach or the other and get great results.  In many cases, there may be more than a simple hump to be taken down (such as minor deficiency in the radix region).  Full-sized, standardized photographs and exam would be needed.  I would suggest a consultation to determine if radix augmentation, dorsal hump shaving, or even a little of both would be ideal.  These can be done through both open or endonasal approaches. 

John Harbison, MD
Omaha Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.