Limitations of Closed Rhinoplasty?

My preferred approach is a closed rhinoplasty.
Critics of this approach say that it is more difficult to perform complex maneuvers of the tip of the nose. They also feel that it is more difficult to work on the septum using this approach.
I have a lot of experience using the closed approach for complex tip and septum work. I personally feel that there is nothing that can't be done using a closed approach.
However, I recognize that some surgeons feel that the open approach is better.
I think that it all depends on the surgeon and how comfortable you feel with the surgeon's ability. If they show you great results that are consistent with what you want, then it really doesn't matter which approach is used.

The limitations of closed rhinoplasty are the lack of the extensive exposure that you have when performing an open rhinoplasty. When a rhinoplasty is particularly complex or requires many grafts, it may be more difficult to achieve with a small incision.

We have been doing open rhinoplasty for more than 30 years. In those days we were called heretics! Today, almost all rhinoplasty surgeons do open rhinoplasty on many of their patients. But there are some noses I still do closed. It depends on many factors.
You should choose an experienced rhinoplasty surgeon who does natural looking noses that you like. Then let him guide you as to which is for you.

Hi Ricardo,
Open and closed are approaches to performing the rhinoplasty operation. I agree with both Dr. Waldman and Dr. Pearlman that excellent results can be achieved with both approaches. Dr. Rollin Daniel, a very well respected Newport Beach rhinoplasty specialist takes it one step further and performs a "closed to open" rhinoplasty.
Personally I find it easier to secure cartilage grafts with the open approach.
Choose your rhinoplasty surgeon based on results, skill, experience, and the noses of the office staff (if they have been operated on by the surgeon).
Good day.
Dr. P

Limited tip work and slight reduction in the "dorsal hump" region of the nose can be done via a closed approach. More extensive tip work and significant reduction in the height of the nose usually requires the open approach. Both can be done as an outpatient and are pretty well tolerated. Good luck!