Am I a candidate for closed rhinoplasty? (Photo)

Question

I am considering a primary rhinoplasty and wondered if I am a candidate for the closed approach? I would like the hump removed to create a straighter profile and some tip de projection. I want natural changes. If I am a candidate, how much would need to be removed? Thanks

Randal Haworth, MD, FACS · Answer

There will always be surgeons who will do closed rhinoplasties for every nose job problem. But the truth of the matter is is that once all the swelling has left after the closed rhinoplasty, one can be left with asymmetries and irregularities that may have gone unnoticed while the procedure was being performed. An open rhinoplasty affords better visualization for the surgeon so that they can directly compare the left and the right cartilages at once. Consider working on a car engine but only through the left and right wheel wells versus opening up the hood and getting a Birdseye view of the total engine. Therefore, the only way to see if you’re a true candidate is to see all views of your nose and assess the symmetry. If you’ve got really good symmetry to begin with, then, in my eyes, you would be a good candidate for a closed rhinoplasty. 
Of course, seek multiple opinions till you’re comfortable. Good luck.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photo. You appear to be a candidate for rhinoplasty to correct the issues you mentioned. During this procedure, the dorsal hump can be decreased, the tip deprojected, and the nose straightened for a natural-looking result. Closed rhinoplasty is ideal for patients who require less extensive changes, though the right approach for your case should be determined after a thorough in-person examination. 
It’s important to note that rhinoplasty, whether open or closed, is one of the most complex of all plastic surgery procedures, requiring experience, skill, and even artistry to achieve an optimal outcome. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon, with expertise in rhinoplasty techniques. They will be able to discuss your aesthetic goals with you to determine the best approach.

Suleyman Tas, MD, FEBOPRAS · Answer

Dear Philosophical391853, 
Thanks for your question. You may get your nose slimmer and your bulbous tip more defined than it is now with Closed Atraumatic Rhinoplasty without cutting the tip of your nose. As long as you set realistic expectations your goals seem achievable with a Closed Technique without opening your nose in a relatively short downtime. Your nose can be slimmed from the front, hump and droopy tip eliminated, bulbous tip refined. Possible breathing issues can be addressed at the same session. Make sure to choose an expert in a nose job, since it is a complex surgery which requires an extended experience. To find out more information about the procedure and criteria in searching a doctor please see the link below. 
Regards, 
TAS TEAM

Zoran Potparic, MD · Answer

The only thing one can conclude from this photos is that you are a good candidate for rhinoplasty. Whether it is done open or closed is decision that you should leave to your surgeon. In person consultation with a board certified pastic surgeon, expert in rhinoplasty, is recommended. Good luck.

Gurkan Kayabasoglu, MD · Answer

Hello. All your issues can be addressed to a well-executed rhinoplasty in the right hands. You can achieve the look you want with Rhinoplasty performed with piezo technique, which is the latest technology. Piezo technology can be used in open rhinoplasty surgeries. Rhinoplasty with the piezo technology will be able to protect your soft tissues and provide you maximal healing. You can visit the link below to get more information about Piezo technique. I would advice to to investigate your surgeons long term results. It is the best indicator to choose a good surgeon for you. While searching your surgeon, please be careful about whether all his results are similar with each other or not. Some surgeons replicate his results to all his patients. If you see the same noses on all of your surgeon's results, it is an indicator that he does not designs his results custom made. Unfortunately, most of the surgeons have similar results with each other and very rare of them, like me, performs custom made surgeries. One golden rule: Please do not have the surgery when you feel uncomfortable and have doubts with a surgeon who you feel hesitated about. The point you need to be careful while searching for the best surgeon is the time between the before and after photos of your surgeon. The after pictures should be at least 1 years after the operation. Early results and intraoperative comparison photos have no value. Secondly, please be sure that you have a good communication with your surgeon and he totally understands you. You can have more detailed information about me and ask questions about your case to my assistants from the number at my profile ( +90 539 204 40 90) . You can also book an online consultation and discuss your issues with me. Best regards.

Ryan Rebowe, MD · Answer

Closed rhinoplasty is an excellent approach to the nasal dorsum, therefore your dorsal hump could be removed via a closed approach. However, the nasal tip deprojection will get trickier through a closed approach and if this is something you would like to pursue I would make sure your surgeon of choice does a lot of closed approach rhinoplasty. The reason for this is that only an open approach really gives you a lot of access to the nasal tip cartilages, and the closed approach is often more of a nuanced approach to the tip.

Eric M. Joseph, MD · Answer

You appear to have thin nasal skin which is prone to show irregularities after rhinoplasty. In our experience over 24 years, the open approach allows direct visualization of the nasal tip, and in our hands, leads to consistently natural appearing nasal tip results. Hope this helps! Dr Joseph

Robert Ciardullo, MD · Answer

Closed rhinoplasty: closed rhinoplasty is excellent for reducing a dorsal hump, shortening a long nose, reducing the projection of an over projecting tip, refining the tip, and elevating or rotating the tip upwards when necessary. You would therefore be an excellent candidate for a closed rhinoplasty. Since closed rhinoplasty is more difficult than open and requires much more experience you should seek someone who has done many many many of them. Open rhinoplasty is preferable for complicated nasal tip work particularly revisions requiring multiple grafts since the exposure is better for those cases with open Rhinoplasty.

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