Can I have a closed rhinoplasty with a deviated septum? (Photo)

Hello and thank you for your question. Based on your
photograph, you may benefit from a septoplasty and spreader grafts to help straighten your nose.  This can be done with either open or closed technique.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and not just a computer animation system. The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Twisted noses are difficult.  Septorhinoplasty will be required.  Open and closed approaches have different pros and cons and you should ask your surgeon their preferred approach and why so you feel comfortable you understand what is suggested and why.  The experience of the surgeon is more important than the approach.  Either approach can address your concerns.

Yes it's possible to have a closed rhinoplasty with a deviated septum, but your photos show quite a bit of external deviation, and so I would recommend you also address the septum at the same time.

Both open and closed techniques are used routinely to fix your problem.  The most important thing is that you have a qualified surgeon you can trust.
Hope this helps.
Dr. Ali Mosharrafa

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 based on limited 2 dimensional photos 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) that you trust and are
comfortable with. If you live outside of the United States, the surgeon should
ideally be a member of the International Society of Aesthetic Plastic Surgery
(ISAPS). You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La
Jolla, California
 

If a surgeon is trained in both open and closed techniques, the the determining factor to use one over the other will be the nature of the tip cartilage. If a work is needed there then an open tip has an advantage especially in thin skin people. If the tip is good and does not need work then the closed technique has an advantage of no scar. The septum can be equally repaired in both techniques. The main reason that surgeons chose one over the other is the way they feel safer or better trained. You will need to find someone trained in both so that he will chose the technique that suits your nose most rather than a technique that suits his training or comfort.
Best of luck, 
Shady Hayek

It can be performed closed or open, depending on surgeon preference. Closed will have less control for the surgeon to straighten it adequately, but it can be done. I perform both, but my preference would be open for you to get the best results. Good luck!

Hello,
You seems to have very sever deformity of nose.
Septoplasty can be combined with open or closed either type of rhinoplasty depending upon surgeons choice.
Severe deformity like yours is better corrected with open Rhinoplasty.
I wish you all the best