What Hurts Less - Open Rhinoplasty or Closed 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 

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. 

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.

There are no studies that I am aware of  to say one way or another. Pain is a very individual thing.   The pain from rhinoplasty is usually well tolerated.  Ice, elevation, and modern pain medicine all help to make this a very tolerable experience. 

I couldn't find a single published study comparing pain between the two nor have I ever seen a measurable or consistent difference in pain between open rhinoplasty and closed rhinoplasty. I suspect that--patient factors aside--the gentler surgeon probably produces less trauma and thus less pain regardless of approach. Find a surgeon who's gentle when examining your nose in the office and who doesn't take a hurried approach. 

All the best,

--DCP