Can a closed rhinoplasty be performed on a patient with thick skin and a bulbous nose? (photo)

Hello all to my patients I recommend to do open up rhinoplasty surgery because it is better you can see all details during the surgery

Hello! I suppose you could undergo a closed rhinoplasty. People often fear the incision on the columella. If done well, it's almost unnoticeable. The open approach allows for precision and the ability to place strong cartilage grafts like a caudal septal extension. This graft allows for significant, strong projection which is often needed for narrowing a bulbous, thick-skinned nose. This can be done through a closed approach but it is very difficult. I would seek consultation with a number of surgeons who perform both techniques. Hope this is useful to you!