Closed or Open Rhinoplasty Better for Revision?

Both Open and Closed Rhinoplasty Techniques and Approaches can be used. The choice of technique depends on several factors including the extent of the correction needed, the degree and location of the deformity, your expectations and the rhinoplasty surgeon's preference.

Most importantly, you should choose your surgeon carefully. Revision Rhinoplasty is a challenging procedure. You would be best served by someone who has  passion for this procedure and has extensive training in all aspects of nasal surgery. Make sure that you are confident in their ability and skills. You want this to be your last procedure!

Hope this was helpful.

Dr. Sajjadian

The open rhinoplasty approach is typically the approach of choice for complex primary and revision Rhinoplasty and allows for both proper diagnosis and precise correction of deformities

It really depends on what corrections are needed, as well as your surgeon's preference. Since you have already had an open procedure, I would personally do an open rhinoplasty revision again. This will give the surgeon my control.

In my opinion, if the revision is extensive in nature and requires a lot of grafting and additional surgery, it is best to have an open approach so that previous areas can be addressed without guesswork. That being said, for more limited revisions, we often will do a closed approach. The most imortant question to ask is what is being done and how the surgeon can specifically address the issue being corrected. I hope this information helps.

Both approaches are appropriate depending on the surgeon's comfort with that method.  An open approach for revision surgery deals with more scarring and a more difficult dissection, but allows better visualization and placement of cartilage grafts.  There is slightly more swelling after surgery with an open approach.  If a small hump needs to simply be filed down more, a closed approach may be appropriate.  There is less swelling after surgery with the closed approach. 

In a complex case such as you describe, and with a history of already having an open procedure, the open techniques are most likely to give you some resolution of your concerns. 

I think that a revisoin is often best done by opening the nose.  Opening the nose provides better visualization of the soft tissues and nasal framework.

The issue should not be the technique used but rather the experience of the surgeon . I personally utilize different techniques in different situations.

Most good rhinoplasty surgeons, using both open and closed approaches, apply these techiques based on their own personal experience. Pick the surgeon, not the surgical procedure. Find an excellent, experienced revision rhinoplasty surgeon and follow his/her recommendations.