Can Closed Rhinoplasty Be Used to Lower and Narrow the Nose's Bridge?

Question

I've heard that closed rhinoplasty causes much less swelling and bruising and requires less recovery time. I can't take much time off of work for recovery, so I'm very interested in this approach. However, besides tip work, I would like to lower the bridge of my nose and possibly make it a bit narrower. Can this be done with closed rhinoplasty?

Ali Sajjadian, MD, FACS · Answer

Both closed and open rhinoplasty techniques can be used  to accomplish most rhinoplasty procedures. You could go back to your routine non-exertional activities fairly quickly with both techniques.

	Depending of the skill of the surgeon and the manuevers they use, you could have very similar amount of swelling and bruising, regardless of the approach used (open or closed).

	The bridge of the nose can be lowered and narrowed, and tip work can be  done with both open and closed rhinoplasty. The open rhinoplasty approach allows for better binocular vision and accuracy. 

	The training, skill and expertise of your surgeon will directly impact the result and not the type of incisions used.

	Hope this helped.

Eric M. Joseph, MD · Answer

There are many excellent rhinoplasty surgeons that predominantly use a closed approach for Rhinoplasty Surgery. I prefer an open approach for Rhinoplasty Surgery when tip work is involved. In my hands, downtime is less than 2 weeks with an open approach for the majority of my patients.

	I see excessive lobule-show on your frontal photo. This is the part of your nose between your tip and columella. This may be improved by dividing your tip cartilages, and straightening your entire lobule-columella with carefully placed sutures and a columella-strut. Maneuvers like this are facilitated by an open approach.

	I hope this is helpful for you.

Richard W. Westreich, MD · Answer

All the changes you describe can be accomplished with both approaches.

	I do agree that closed has less swelling, but that usually has to do with the tip region.

	Bruising will be the same in both cases, as it is the result of bone work. This work is done the same way in both closed and open approaches.

	There are a lot of things you can do to minimize bruising and swelling. I give patients Arnica and Bromelain capsules to help with swelling. I also work with a nutritionist (I use nutritous life in NYC) to provide patients with additional information. I find that it does make a significant impact on the healing process.

	Best of luck

Toby Mayer, MD · Answer

The difference of the two ways is based on what is needed and how experienced the surgeon is. My practice is 50% revisions noses done somewhere else. Of these 1/2 were done open and the other 1/2 done closed. Therefore, it is not the type of procedure your should concern yourself with, since the swelling and bruising are the same. We pioneered "open rhinoplasty" in the USA more than 35 years age and there are still many noses I do closed. Pick a surgeon who does "natural" looking noses and forget about the approach.

Scott Trimas, MD · Answer

The choice of the approach is often dependent upon the surgeon's preference in conjunction with the wishes of the patient. You are right in that swelling especially of the tip area is much longer for an open versus a closed approach. Most noses can be successfully treated either way. I usually reserve open approaches for revision nose surgery or where a lot of grafting is required or if the nose is crooked and if it needs to be signficantly lengthened. In your case, it can certainly be accomplished with either approach. I hope this information helps.

Otto Joseph Placik, MD · Answer

Yes, a closed rhinoplasty can be used to lower the height of the nasal bridge as well as to narrow the nose in addition  to tip rhinoplasty.

William Portuese, MD · Answer

Closed rhinoplasty can be used to perform nearly all rhinoplasty techniques including lowering and narrowing the bridge, tip, and mid third of the vault placing spreader grafts, tip grafts, and sewing the tip cartilage together to refine the bridge.

Darryl J. Blinski, MD · Answer

Yes all the issues you are concerned with can be addressed via a "closed Rhinoplasty" approach. It is better to see a few consultants doctors in person to discuss these issues. Best of luck from MIAMI Dr. B

Peter A. Aldea, MD · Answer

The Closed VS Open Rhinoplasty debate has been over for years and does not need to be restarted. The vast majority of nose operations can be done with a closed rhinoplasty. An open rhinoplasty is unrivalled in visibility and versatility. 

Discuss your desires with your Plastic surgeon and let him guide you

Dr Peter AAldea

Steven Wallach, MD · Answer

While open techniques in rhinoplasty will cause more swelling, I prefer and I think most rhinoplasty surgeons prefer to perform rhinoplasty open to have the most control with the anatomical structures.

Can Closed Rhinoplasty Be Used to Lower and Narrow the Nose's Bridge?

Answers (13)

More Rhinoplasty Questions

Removing Scabs in Nose from Rhinoplasty?

Swollen Tip 5 Weeks After Rhinoplasty

Will Calcium and Vitamin C Help Post-rhinoplasty Healing?

How Can I Tell if I Have Thick or Thin Nasal Skin?

Can You Lose Your Hearing After Rhinoplasty?

Bruise from Pinching Nose After Rhinoplasty

WE SEND PRETTY
EMAILS