Open or closed rhinoplasty? (photo)

I will have closed rhinoplasty performed in 3 weeks. I've done so much research and can't cone yup the conclusion as to which one is better. I know they are very different and very doctor pereforms differently. My surgeon prefers the closed approach because that is what he was taught. I trust him. But I'm do nervous and have doubts. Any suggestions? Here are some pictures of myself and the nose that I would like to have (or similar).

Doctor Answers 13

Closed verses Open Rhinoplasty

Thank you for your question. As a member of The Rhinoplasty society the majority of us can perform both open or closed rhinoplasty. I perform both open and closed rhinoplasty. In reviewing your photographs, in my opinion you are a candidate for an open rhinoplasty. It is important to remember the comfort level of your surgeon and the approach he recommends.  Best wishes in your upcoming surgery! Sincerely,James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society,

Pittsburgh Plastic Surgeon
4.9 out of 5 stars 64 reviews

Performing rhinoplasty without external incisions

The debate between open or closed may never end. As other rhinoplasty surgeons have stated, either approach can be appropriate. The method (ie. open or closed) the surgeon accesses the nasal cartilage or bone may not be as important as to what is done to the nasal cartilage and bone. I perform primarily closed rhinoplasty, even in revision rhinoplasty. However, every physician will vary, and trusting your surgeon is important. 
Best,Dr. Chaboki

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 77 reviews

Open or closed is not important

what is important is what is done during the surgery. Open versus closed doesn't determine that. If your surgeon prefers closed, then go with that. It's all the other manipulations during surgery that matter (sutures, grafts, cartilage excision, skin thinning) the most. I do mostly closed but I do all the same things that most surgeons do open. It's preference more than anything else. Technique determines results. 

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 44 reviews

Open or Closed Rhinoplasty

Nasal surgery may be performed using an open or closed technique. With an open rhinoplasty the tissue is manipulated through a small incision made on the tissue separating the nostrils, known as the columella. This technique allows the surgeon greater access to the structure of the nose to better add support and treat issues. This small incision made at the base of the nose is very small and heals into a fine line that is difficult to see. A closed rhinoplasty does not require an external incision, but it may only be used in certain cases as there are limitations. Incisions will be made entirely within the nose. It is up to the Surgeon and his expertise when deciding what type of Rhinoplasty he would like to perform. 

Closed versus open rhinoplasty

Closed versus open rhinoplasty is only about the approach, not what is accomplished on the inside of the nose. Closed rhinoplasty involves placement of all of the incisions on the inside of the nose,  while open rhinoplasty involves the very same incisions on the inside of the nose with an additional incision across the columella. More important than the approach, is the results of your surgeon has demonstrated in their before and after  photo gallery on noses that are similar to your own. For more information and many examples of close rhinoplasty, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Rhinoplasty Open Vs Closed

The procedure that works best is the one that your surgeon get the best results from. Open rhinoplasty allows the surgeon to see the underlying structures without pulling upon them.  This allows the cartilage and bone to be sculpted without any distortion producing a natural and refined nose.


Open or closed is surgeon dependent. I prefer to perform the majority open because I feel in most cases you have better visibility of the underlying structures.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews


You can get a nice result with either technique.  You would benefit from tip refinement, tip upward rotation, slight dorsal reduction with bridge narrowing and slight alar base narrowing.  All these steps can be done with either technique and different surgeon have their own preferred technique.  The better exposure provided by the open technique is the reason it is preferred by a majority of surgeons these days.  Best wishes, Dr. T

Open or closed rhinoplasty

There is no one "right way". If your surgeon feels confident that he can get you the result you desire with a closed approach then you should be ok with that. See  photos of other patients he has done and be sure you like his results. It's a mistake to try to fit yourself into any named technique, but rather have your surgeon use whatever techniques he/she is comfortable with to get you your desired result.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.7 out of 5 stars 9 reviews

Open or close rhinoplasty?

Without hesitation I recommended open rhinoplasty for you.  In my experience, closed rhinoplasty limits what you can do. Open rhinoplasty allows to the visibility to perform for size maneuvers and shaping that otherwise is not possible.

Adam Hamawy, MD
Princeton Plastic Surgeon
4.7 out of 5 stars 42 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.