Will closed Rhinoplasty technique to fix crooked nasal bones and septum cause tip swelling that lasts longer than a few months?

45 year old female. Primary rhinoplasty/septoplasty 20 years ago with small revision. crooked nasal bones never fixed & septum crooked again. Cannot breathe through right side. Thank you.

Doctor Answers 9


Secondary rhinoplasty can be tricky whether done by the closed or open technique.  It would help a lot to see photos as well as perform an internal exam to determine what the best way would be to correct the situation.  Straightening the crooked nose can be very difficult.  Although there are many techniques and strategies to straighten the crooked nose, you may still have some slight asymmetry.

San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Closed septoplasty and straightening of the nose bones

Most of the visible swelling will be subsided at 3 months after repair of a crooked nose and a septoplasty. To straighten crooked nasal bones, medial and lateral osteotomies of the nasal bones are performed. Occasionally a cartilaginous spreader graft is placed on the concave side as well. A septoplasty is performed on the internal back portion of the nose to remove obstructing cartilage and bone that is blocking air flow. Both procedures can be performed together. For many examples, please see the link below to our rhinoplasty photo gallery.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Will closed rhinoplasty technique to fix crooked nasal bones and septum cause tip swelling that lasts longer than a few months?

Hello!  Thank you for your question!  The decision for open or closed rhinoplasty is often times a surgeon preference.  Each has its advantages and disadvantages.  Certainly, a closed rhinoplasty will have less swelling since the nasal skin is not lifted.  It is a reasonable decision to have an open rhinoplasty as direct visualization is often times needed since there will be increased scarring from the previous rhinoplasty/septoplasty. 

Given your complaints, both a revision septoplasty as well as the bony work (with possible spreader grafts to improve your breathing via cartilage grafts to open the nasal vault) can be easily done via an open approach.  Although there will be slightly more swelling following this procedure, you should consider the ultimate outcome with these procedures, which, in my opinion, is more feasible via an open approach, especially in revisionary nasal procedures.  Swelling should still subside by a few weeks and is well-tolerated.  The closed approach is also an option, but ability to perform certain procedures for the rhinoplasty portion is limited.

Consult with a plastic surgeon who will discuss with you the various options and help you decide, based on your goals and desires, which is the best method for you.  Hope that this helps!  Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

Revision rhinoplasty

I think that itis always good to see what a person looks like before commenting. But if you feel your nose is crooked and needs a revision, then the first thing you should do is go for an evaluation.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Swelling of nasal tip after closed septorhinoplasty.

Swelling of nasal tip after closed septorhinoplasty is not noticeable after 2-3 weeks even though it will go down over 6-12 months. 

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

Tip Swelling after Nasal Revision

Let me start by answering your question with another question: what does your nose look like, how thick is your skin, and what needs to be done to the tip? A few general comments: there is more post-op swelling after the open technique; there will be more swelling because this is your  2nd revision; the duration of obvious swelling is less than the time it will take to achieve the end result; I need to see pictures or examine your nose.

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

Closed revision rhinoplasty

Thanks for this question. The best treatment can only determined by an in-person examination. In general, closed approaches may have less swelling but might not address affected areas as well compared to open approaches especially in revision cases. Hope this helps. Good luck!

David C. Yao, MD, FACS
Phoenix Plastic Surgeon
4.8 out of 5 stars 7 reviews

You may need spreader grafts, open rhinoplasty may be better


Both closed and open rhinoplasty techniques can provide great results.  However, complicated rhinoplasty cases such as crooked nose, breathing issues, and revision rhinoplasty be best treated with an open rhinoplasty approach.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 166 reviews

Will closed Rhinoplasty technique to fix crooked nasal bones and septum cause tip swelling that lasts longer than a few months?

   Hard to make recommendation about duration of swelling without examining you.  In general, the closed rhinoplasty with minimal dissection will result in less swelling.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 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.