Is Closed Rhinoplasty Best for a Droopy Tip Surgery?

I consulted with doctors who do closed rhinoplasty, and I consulted with ones who do open. Closed seems less risky and more simple for some reason to me, but I am concerned that the results won't be as good. I have a droopy tip that I want to be lessened (same tip, just less droopy) Also, I don't want my nose to be longer from the side. For this procedure, is closed better than open or not?

Doctor Answers 9

Rhinoplasty surgery

Dear sourkid13,

  • You will live with your nose for the rest of your life and so the goal should be a specific result that you will love
  • In my hands, in someone with an already nice tip, I can do a closed approach
  • If there is a lot of asymmetry between the two sides of the tip, then I favor an open appraoch
  • In the end, you should go with the surgeon you are most comfortable with, the technique does not matter as much

Best regards,

Nima Shemirani

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 74 reviews

Closed Rhinoplasty Versus Open For Tip Work

In my humble opinion, I think an open rhinoplasty approach has a big advantage over closed rhinoplasty when it comes to reshaping and repositioning the nasal tip. 

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 40 reviews

Open or closed approach?

Whether an open or closed technique is used really depends on the nature of the patient's issues and what will be necessary to obtain the desired result. An open technique is generally used when more invasive work is necessary, and it gives the surgeon a better look inside the nose. An exam would really be necessary to determine the technique that would best suit your needs. I would recommend a consultation with a board certified rhinoplasty specialist. He or she will be able to examine your nose in person and provide you with the best advice. I hope this helps, and good luck to you. 

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

Closed vs open rhinoplasty

Surgeons can perform rhinoplasty through open vs closed techniques. The only difference inthe incision is that with open there is a 1 cm skin incision on the columella.  The exposure allows precise work to be doen especially on the tip. Closed rhinoplasty does not give them same exposure. Interesting most of the "experts" on the lecture circuits use the open approach.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Opoen versus closed rhinoplasty for droopy tip repair

Both open and closed rhinoplasty approaches are safe options when performed by an experienced surgeon. Depending on the situation and surgeon preference one approach may be preferred compared with the other, especially when it comes to treating issues with tip position, droopiness, etc.

I would focus more on your potential surgeon's results rather than solely on the approach used.

You can read more about droopy tip repair at my web reference link below.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Closed vs Open Rhinoplasty

Excellent surgeons use both open and closed procedures for tip rhinoplasty depending on the needs of their patients and their own personal preferences. I advise you to pick the surgeon based on the results you see in patients like you. Pick the surgeon, not the technique.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Closed rhinoplasty is best in the hands of an experienced Nose Surgeon.

Closed rhinoplasty is best in the hands of an experienced Nose Surgeon.

With a closed rhinoplasty there is no external scar to show that you had the operation. I have been doing closed rhinoplasties for 30 years and am confident that I can produce the desired changes without a visible, external scar. We plan the final appearance on the computer ahead of time and carry it out in the surgery with no 'give away' scar.

G. Gregory Gallico III, MD
Boston Plastic Surgeon
3.2 out of 5 stars 7 reviews

Open vs. closed rhinoplasty for droopy tip

In my opinion, open rhinoplasty is better for tip refinement surgery, as it gives the surgeon better visualization of the tip cartilages. Also, it makes it possible to do precise stitches for sculpting of the tip. 

Ahmed Abdullah, MD, FACS
Fargo Plastic Surgeon
4.9 out of 5 stars 18 reviews

Is Closed Rhinoplasty Best for a Droopy Tip Surgery?

That is a great question. You will likely receive different answers depending on the comfort level of the surgeon- ie some surgeons perform most rhinoplasties via an external approach while others prefer the endonasal (closed) approach. Excellent nasal tip refinement can be achieved with either method. I would not consider opening the nose more risky- in fact certain surgical techniques used for tip surgery are only possible with an open approach. I would not base your decision only on the approach- make sure your surgeon is expert at this type of surgery and that you like the results you see in the before and after gallery. Hope that is helpful. 

David M. Lieberman, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 5 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.