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

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.

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 

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.

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.

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.