What Hurts Less - Open Rhinoplasty or Closed Rhinoplasty?

I Want to Know What Hurts Less Open Rhinoplasty or Closed Rhinoplasty.

Doctor Answers 21

Pain and Discomfort After Open vs. Closed Approach Rhinoplasty

Hi Em,

With anesthesia, neither hurt during the procedure.  There is surprisingly very little pain associated with either open or closed approach rhinoplasty.  With both, you should only feel a slight bit of nasal congestion, and at worst a sinus type pressure headache.  Most patients get by on just plain Tylenol though they are given Vicodin just in case and for at bedtime.  The most uncomfortable aspect of Rhinoplasty is if your surgeon uses intra-nasal packing after the surgery.  I and many other rhinoplasty surgeons no longer use nasal packing so that our patients can experience a more comfortable recovery.  Choose your rhinoplasty surgeon most carefully.

Dr. P 

Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Pain after Open vs. Closed Rhinoplasty

I would expect the pain to be similar after rhinoplasty - open or closed. Suture removal (unnecessary for closed approach) may be uncomfortable after open rhinoplasty but certainly very tolerable with the help of numbing cream.

At the end, pain levels should not determine the rhinoplasty technique used. Rather, whether the surgeon is able to accomplish everything.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Open vs. Closed Rhinoplasty

Thanks for the question. I perform both open and closed (endonasal) rhinoplasty and in my experience, patients report that their postoperative pain is mild with either approach. Pain medication is usually needed for only 2-3 days following surgery.

I would leave it up to your surgeon to decide whether an open or closed technique would be more effective for your rhinoplasty. The decision should be made on the basis of which issues in the nose are being addressed as well as the surgeon's training and experience with each approach. I have found that the small incision on the columella in open rhinoplasty heals quite beautifully and the slightly longer healing time is certainly worth it if your surgeon feels that the results will be better (in his/her hands) with the open approach. 


Dr. Mehta

Umang Mehta, MD
Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Pain During Nose Job

Since pain is experienced completely subjectively, the level of pain you will experience during your rhinoplasty is entirely relative. Either way, you will be administered local or general anesthesia, and should thus be numb to any pain during your surgery. The decision to perform an open or closed rhinoplasty should thus involve the structure of your nose and the goals that you and your doctor have agreed upon. If you are worried about the level of discomfort involved with your nose job, talk to your doctor about post-op care and medications that can be prescribed to reduce pain. 

Sam Rizk, MD
New York Facial Plastic Surgeon
4.7 out of 5 stars 73 reviews

Discomfort should be about the same with both open and closed approaches

Hello Emily

Thank you for the question.  Both open and closed approach to rhinoplasty should have similar discomfort.  The discomfort is primarily from nasal bone in-fracture and from intra-nasal splint/congestion.


All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Rhinoplasty recovery

Does not make a difference what technique is used.  With osteotomies, there is more discomfort after surgery than without .

Vladimir Grigoryants, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 312 reviews

Open or closed Rhinoplasty?

There really should be no difference in the pain level after either an open or a closed rhinoplasty. Either procedure is not particularly painful. Patients usually note a level 1-2 of pain on a scale of 10. The only difference may be in swelling in in the postoperative period.  Every patient has different threshold of pain, so it is difficult to predict. Most of our patients do not take medications other than Tylenol in the immediate postoperative period, however there are those whose medication needs are higher.

John E. Sherman, MD
New York Plastic Surgeon
4.4 out of 5 stars 15 reviews

Pain of open versus closed rhinoplasty?

I am not sure if this has ever been definitively answered. It is my impression that the open may involve silghtly more swelling and therefore more inflammation and pain but this is only an educated guess. In my opinion there are not significant differences in the pain levels.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Difference in post op pain between open and closed rhinoplasty

The closed rhinoplasty is going to hurt less because there is no external incision on the nose. The only difference is the incision across the columella and more sutures. Overall, as long as there is no packing placed inside the nose which can make the nasal tissues very painful in the postoperative period, there is probably not a huge difference between pain associated with the open or closed procedure.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Pain with Open vs Closed Rhinoplasty

Over the last 30 years, I'm not aware of a difference in my patient's post-operative pain, whether I did an open or closed procedure. Pain after rhinoplasty is moderate and controlled with oral narcotics the evening of surgery. The followingg day, most patients use Tylenol.  

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 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.