Can a revision rhinoplasty be performed using the closed technique, if I feel my tip was not refined enough the first time?

Excellent
cosmetic results can be achieved with both techniques. There is not a best way
to perform the procedure. Individual surgeons have their own preferences of how
to produce the best results in their hands. What is more important than whether
a closed or open approach is utilized is the experience and artistry of the
plastic surgeon and your comfort level and confidence in that individual.Following
the advice from a surgeon on this or any other website who proposes to tell you
exactly what to do  without examining you,
physically feeling the tissue, assessing your desired outcome, taking a full
medical history, and discussing the pros and cons of the operative procedure
would not be in your best interest. I would suggest you find a plastic surgeon
with extensive nasal surgery experience who is certified by the American Board
of Plastic Surgery and ideally a member of the American Society for Aesthetic
Plastic Surgery (ASAPS) or a facial plastic surgeon (otolaryngologist) that you trust and are
comfortable with. You should discuss your concerns with that surgeon in person.Robert
Singer, MD FACSLa Jolla, California

Although you can make some adjustments to the nasal tip through a closed approach an open approach gives so much more flexibility, and precision.   The scar is very very rarely an issue. I would strongly favor an open approach.

Although there are some surgeons who will only use either open or closed techniques for rhinoplasty, most rhinoplasty specialists will choose the technique best suited to your needs. In general, closed rhinoplasty allows for less refinement of the nasal tip than the open technique, although there are excellent surgeons who do use the closed technique for tip work. Suturing, graft placement, changes in rotation and projection, and other maneuvers are more precisely performed through an open technique in general. Closed revisions allow for alteration of the nasal bridge and less aggressive tip changes. Of course, a thorough discussion with a board certified plastic surgeon well versed in revision rhinoplasty is needed to determine the best option for you.Thanks for your question.