Closed Rhinoplasty to Refine Tip After an Open Rhinoplasty?

I have had open Rhinoplasty, but I was wondering if the closed approach is a viable option for just some more tip refinement. My tip seems a tablespoon too wide still. I have heard of some PS's entertaining a closed rhino for the 2nd time around if its done for very minimal changes.

What are your thoughts on this? I also have ear cartilage graft in place and wonder if that is a factor?

Doctor Answers 3

Open Versus Closed Rhinoplasty

The question of which surgical approach to rhinoplasty is the "best" -- Open versus Closed -- is one of the most frequently debated topics among Rhinoplasty Specialists. Unfortunately, there is not a simple answer to this question. Each rhinoplasty patient is unique, and therefore each rhinoplasty should be unique.

While many plastic surgeons and facial plastic surgeons perform rhinoplasty, very few specialize in secondary (revision) rhinoplasty. Post-rhinoplasty deformities can be very complex and require significant experience to correct. Most revision rhinoplasty specialists perform secondary rhinoplasty via the open approach. This allows the surgeon to directly visualize the deformity.

I recommend that you not only speak with your surgeon about your concerns to see what he or she recommends, but also consult with one or more revision rhinoplasty specialists.

Dallas Facial Plastic Surgeon
4.7 out of 5 stars 146 reviews

Revision Rhinoplasty

Nasal tip revsion surgery after prior extensive cartilaginous grafting can be a challange. Minor revisions can often be performed via a closed approach with additional grafting or shaving of scarred cartialge. In my hands, major revsions can be best assessed and corrected with open technique. Often, extensive scarring occurs distorting the underlying cartilage and grafts requiring major restructuring.

Lee Kleiman, MD
Annapolis Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Forget the technique--go to a good revision rhinoplasty specialist.

 We were 2 of the first 4 surgeons in the US to pioneer open rhinoplasty. Having said that, we see many patients for revision who have been done both ways. The key is to see an experienced revision rhinoplasty surgeon and have him give you the pros and cons of doing the tip open or closed.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 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.