Should I get a closed or open rhinoplasty? (photo)

I broke my nose when I was 10. I can't breathe almost at all out of one nostril, and there is a small bump. I also think that my nose sticks out too far off of my face in comparison to my small chin and mouth. Do you think the tip and columella droop a little too much? I have a very nice nose tip. If I wanted my nose to not stick out as much, would I need to touch the tip? I wanted to shave the spot in between my eyes down a little too.

Doctor Answers 20

Closed rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Closed rhinoplasty techniques can accomplish the goals you are looking for by reducing the small hump, reducing the projection of the nose, and trimming back the prominent columellar show with a columellar-plasty. Minimal if any tip work is needed. For many examples of noses similar to your own, please see the link below to our closed rhinoplasty photo gallery

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Open or Closed Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Based on your pictures alone and without the benefit of an examination, it appears you are a great candidate for a rhinoplasty. There is no reason that a closed rhinoplasty can't be performed and give you a satisfactory result.
The bump, the septum, and the projection can be addressed with a closed rhinoplasty.

But the real answer to your question is it is not the technique, it is the surgeon. Consult a Board Certified Plastic Surgeon with rhinoplasty experience.

Best wishes

George C. Peck, Jr, MD
West Orange Plastic Surgeon
4.8 out of 5 stars 25 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is important to find a PS who can give you the look that you want communicated via digital imaging. It is not the approach but the final result that is important and you should find that surgeon you are comfortable with who can give you the result you want. Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Open vs Closed Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Good results can be had with either approach in your case. Personally I would offer a closed approach based upon your anatomy and concerns. A reduction of your bridge will likely recess the tip but the tip does not need to be touched if it is not a concern of yours.You may have a septal deviation as well which could be addressed at the same time as the cosmetic work. Your concerns are very reasonable and I think that you could expect a great result once you find an experience surgeon. Best of Luck   Dr Harrell

Closed v.s open rhinoplasty for nasal reshaping

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Based on your facial analysis and nasal profile, you have slight dorsal hump and over projected tip with poorly defined supratip. I would recommend an open septorhinoplasty to achieve and excellent aesthetic and function for your nose. The end result would be a smaller and harmonious nasal features with better breathing. Good luck.

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 224 reviews

Open versus closed rhinoplasty options

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It's hard to say what would be the best option for you without an examination and seeing more views of your nose.

It also depends a bit on your surgeon's preferences. I do get a sense of some prominence to your columella in your photos. This can be addressed with rhinoplasty along with smoothing your bridge.

Since you are also having trouble breathing out of one side of your nose you would want to make sure that your surgeon addresses that aspect of things as well.

You can check out my web reference below to read more about open versus closed rhinoplasty.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Closed or open rhinoplasty?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The areas that concern you can be improved with either an open or closed rhinoplasty.

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 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 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


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
The rhinoplasty technique employed by a surgeon is typically dependent on the surgeon's preference.  There are rarely absolute indications for either.  In my practice, I perform both "closed" and "open" rhinoplasties, depending on patient's aesthetic goals.  Difficulty breathing out of one side of the nose can result from a variety of issues that would be determined on a doctor's exam. Decreasing nasal projection (how far the nose sticks out) is commonly accomplished during rhinoplasty. It is possible that you may have the slightest bit of excessive "columellar show" that can also be corrected during rhinoplasty.
There is no reason why you can't have a nose that both looks good and functions well. Make sure to consult with an experienced rhinoplasty surgeon.  Good luck!

Jeffrey B. Wise, MD, FACS
Wayne Facial Plastic Surgeon
4.9 out of 5 stars 170 reviews

Closed vs Open Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
This is a question I'm asked everyday. Although I am a big fan of open procedures in revision surgery and cases where augmentation grafts are needed (we are two of the first four surgeons to do open rhinoplasty in the United States) I feel that this technique is actually overused today. I agree that your profile should be reduced and your hanging columella can be lifted without changing your "very nice nose tip".

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Rhinoplasty Options #rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

All the maneuvers you talk about are possibilities. It is our job to listen to you desires and determine what maneuvers will give you the look that you are trying to obtain. Your questions will be best answered in a consultation with a plastic surgeon.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 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.