Closed Rhinoplasty- Tip Work?

Is it possible to obtain a narrowing and refining of a bulbous tip with a closed rhinoplasty?

Doctor Answers 10

Tip rhinoplasty

The choice of approach, open or endonasal (closed) depends on the anatomy of your nose and, to a large extent, the surgeon's personal preference.  Yes, you nose can be narrowed through an endonasal approach; just make sure you choose a surgeon who does a lot of endonasal rhinoplasty.

Boston Facial Plastic Surgeon
4.5 out of 5 stars 26 reviews

Closed Rhinoplasty For Bulbous Tip

Dear Jules,


Depending on the symmetry and shape of your nose, open or closed Rhinoplasty is best.


Without physical examination, it is hard to assess your current status.

I encourage you to seek consultations with board certified surgeons who will help you make a well informed decision.


The best of luck to you.

Dr. Sajjadian


Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 197 reviews

Correction of Bulbous Tip with Closed Rhinoplasty

If the only problem is that the tip is bulbous, this can be corrected with a closed procedure. However, I do recommend an open approach for many other tip problems especially if this is a revision.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Tip work through closed rhinoplasty.

Yes the nasal tip can be narrowed and refined through a closed Rhinoplasty approach. Most expert Rhinoplasty surgeons will  perform either open or closed approaches depending on the particular situation, Both have pros and cons. Discuss these with your surgeon so that you are fully informed.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 108 reviews

Open verses closed Rhinoplsty for Bubous tip

I have been using both the techniques for past 30 years and each approach has its indications.If the nose tip feels fatty tissue mainly then perhaps an open rhinoplasty will be simpler for the surgeon to perform and give a better result however if its the thick large bulbous lower Alar cartilage is the cause a closed rhinoplasty will be good take care of it.


Ashok Govila, FRCS, MCh, MS
Dubai Plastic Surgeon
4.7 out of 5 stars 88 reviews

Rhinoplasty Approach for Tip Work

The answer to your question is "It depends".  The "closed rhinoplasty" to which you refer only describes the approach, not what is actually done.  The same techniques to refine the nasal tip are done through both open and closed approaches.  The important determinants as to which is used are the degree of deformity, asymmetry, skin thickness, and experience of the surgeon with one or the other.

In my hands, I will usually recommend an open approach if there is significant tip work to be done.  The scar is almost imperceptible and the exposure provided allows me to be much more precise in my correction. 

James Bartels, MD
Manchester Facial Plastic Surgeon
4.7 out of 5 stars 12 reviews

Closed Rhinoplasty- Tip Work?

 Yes, I have used both Open and Closed Rhinoplasty for over 25 years.  It depends on the shape of the nasal tip as well as the existing tip symmetry and angle of rotation as to which Rhinoplasty technique is best in your particular case.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Closed rhinoplasty can correct tip asymmetries

Of course before there was open rhinoplasty, closed rhinoplasty was used even for bulbous or asymmetric tips. A good surgeon should be skilled in both open and closed approaches to rhinoplasty. If the columellar scar is not right for you, keep looking for a surgeon who is not uncomfortable with a closed procedure.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Tip work with closed rhinoplasty.

Tip work with closed rhinoplasty can be done if there is relative symmetry of the tip. For t

35 years I have pioneered Open rhinoplasty when there is asymmetry and need for cartilage grafts.

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

Bulbous Tip Reduction through a Closed Rhinoplasty

Hi, It depends on whether you have a cartilagenous orĀ  fatty bulbous. If you have large bulbous lower lateral cartilages and thin skin, then a closed rhinoplasty should do the trick. However, if your nasal tip is at all fatty with weak, flismy lower lateral cartilages, then a closed rhinoplasty is not the way to go. An open rhinoplasty for a fatty bulbous tip allows for removal of fatty tissue under the nasal tip and precise placement of cartilage grafts. Best, Dr.S.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 274 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.