What is the difference between closed rhinoplasty and open rhinoplasty?

Doctor Answers 16

Difference between open and closed rhinoplasty

In essence, an open approach makes an  incision across the columella. Closed has no scars. Both procedures may need to do an alar base resection, which leaves small scars in the crease behind the nostrils.

I have never done an open rhinoplasty. I get enough exposure in a closed technique to do what is needed. Mostly, those that do open are those that are not comfortable doing closed and have had more training and experience with open technique.
That said, for me there are drawbacks with open technique, even though it can give good results, I think close technique looks more natural.

Great Neck Plastic Surgeon
5.0 out of 5 stars 6 reviews

Closed vs open rhinoplasty

I prefer in most cases to perform open rhinoplasty. This adds a small incision along the columella to lift he soft tissue off the underlying cartilage and bone.  It gives direct visualization to allow for precise maneuvers to improve the appearance of the nose. Occasionally  I do closed rhinoplasties.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

What is the difference between closed rhinoplasty and open rhinoplasty?

  Hi, I have performed many open and closed Rhinoplasties over the past 30 years.  Closed Rhinoplasty means that all the incisions are hidden inside the nose.  Open Rhinoplasty has an inverted "V" incision placed along the mid-columellar region, on the outside of the nose, that connectes to more incisions on the inside of the nose.  The open technique, IMHO, is reserved for the following situations as it offers the ability for more direct interaction with the nasal tip cartilages.

  • Very wide nasal tip
  • Severely crooked, asymmetric or previously operated crooked tip
  • Severely under rotated nasal tip
  • Requires placement of a cartilage graft to the tip for added symmetry/support
This techniques does take more surgery time and a longer recovery time because of the added tissue dissection over the entire nasal tip area.  Hope this helps. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Closed vs Open

As an experienced nose surgeon who was trained during the time before we did open noses routinely, I feel that closed is the better techniques as it avoids an incision that can be quite visible. I can do anything via a closed rhinoplasty that the younger doctors of today want to do open. 

William B. Rosenblatt, MD
New York Plastic Surgeon
4.1 out of 5 stars 11 reviews

What is the difference between closed rhinoplasty and open rhinoplasty?

The differences are a matter of style, training and most recently, an option depending on what needs to be done anatomically.

Historically, closed rhinoplasty(all internal incisions) was how rhinoplasty began. However, it was mostly a "hump" reduction operation. As knowledge of the nasal anatomy and intricacy of the surgery evolved, open rhinoplasty became more popular because it was felt to be more accurate anatomically and stable architecturally---hopefully leading to fewer late revisions.

I was trained in closed rhinoplasty, however, today I do most complex airway, nasal straightening and tip sculting operations "open"(the scar has been a non issue in my experience as well as in studies); I do isolated bony work and augmentation rhinoplasties closed.

In short, it depends on what your nose requires and the training of the doctor.
Hope this helps

Andrew Kornstein, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 12 reviews

Closed versus Open rhinoplasty

Closed rhinoplasties have no visible incision across the bottom of the nose. I use them for most primary rhinoplasties were reconstruction of the nose is not required. An open rhinoplasty involves an incision across the thin lower part of the nose and has varying degrees of visibility. It is useful for more complex nasal surgeries.

Garrett H. Bennett, MD
Manhattan Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Q: Difference between #openrhinoplasty #closedrhinoplasty

The difference between between the open and the closed is essentially that with an open rhinoplasty there is an incision that is made across the base of the columella of the nose between the two nostrils. It allows better visualisation of the nasal tip particularly and preferred when more detailed surgery is planned. A closed rhinoplasty performed entirely through incisions made within the nostrils.

Sultan Hassan, MD, FRCS(Plast)
London Plastic Surgeon
4.9 out of 5 stars 70 reviews

Closed vs Open Rhinoplasty

The surgery is either performed through the nostrils, or the nose is "open" to better visualize its underlying structures.

Incisions are the same, except for one. In open rhinoplasty theres a columellar, between the nostrils, incision. This allows for full visualization of the nasal structures. 

Open rhinoplasty affords better visualization and more precise maneuvers during the surgery, and the external incision should be seamless after healing.

Michel Siegel, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 111 reviews

Closed versus open rhinoplaty

Closed versus and open rhinoplasty are simply approaches to rhinoplasty.  They say nothing about the results.  It is best to look at physicians' long term results and what they are able to accomplish with their technique.  

Open versus closed rhinoplasty

 The only difference between the 2 approaches is that closed rhinoplasty does not involve the incision across the columella, on the outside of the nose. The remainder of the incisions are the same on the internal portion of the nose. Closed rhinoplasty approach can still accomplish advanced cartilage grafting techniques, hump removal, tip suturing techniques, a full tip rhinoplasty, spreader grafts, and osteotomies.  Some surgeons are comfortable with a closed approach, and some surgeons are more comfortable with an open approach. More important than the approach is the experience of the surgeon to deliver the results which you are looking for. For many examples, please see link below to our closed rhinoplasty photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 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.