Does surgery for saddle nose require special training? Is it better to do closed or open?

Question

Hi, I was told I have a saddle nose, and I am wondering if closed or open rhinoplasty is suggested for me. I do not like the look of the nostrils I see in open rhinoplasty. I also want my tip to be slightly refined, and I hear this is difficult with closed rhinoplasty

Andrew Miller, MD · Answer

It takes special training to perform any rhinoplasty. So for consultation you should be going to a surgeon with a lot of experience in rhinoplasty over the years that has a lot of photos that you like. Usually a graft of some sort is needed to build up the nose and fixing the tip precisely is definitely easier with an open rhinoplasty. A properly perfomed open rhinoplasty has nothing to do with the nostril shape - that has to do with improper cartilage manipulation under the skin.

Semih Yildiz, MD, FEBOPRAS · Answer

A saddle nose is not simply a cosmetic bridge reduction. The surgeon must identify why dorsal and septal support were lost, assess the airway, and rebuild a stable framework with septal, ear, or rib cartilage depending on severity. Previous trauma or surgery, septal perforation, infection, inflammatory disease, and intranasal drug exposure should be evaluated before reconstruction. Open versus closed is an access choice, not a style of nostril result. An open approach gives broad exposure for major septal reconstruction, graft fixation, and asymmetric tip work, so it is often chosen for moderate or severe collapse. A closed approach may be suitable for a mild deformity in experienced hands and can also refine the tip, but it offers less direct exposure for complex rebuilding. Nostril shape depends on the underlying anatomy, tip and alar support, graft placement, and healing rather than the external columellar incision alone. Choose a surgeon who regularly treats functional saddle-nose cases and can show long-term results similar to your anatomy. The operative approach should follow the reconstruction required, not fear of one incision.

Ahmet Altintas, MD · Answer

Open rhinoplasty or closed rhinoplasty has no big difference when it compared to each other. The only difference is 5mm cut under the nosetip. The important factor is that the doctor's approach to the case and how satisfied you are with the expected results.

Gary DeCesare, MD · Answer

In general, open rhinoplasty versus closed rhinoplasty are often determined by the preference of the surgeon. However, open rhinoplasty is usually utilized when the complexity is increased, or when significant work is required on the nasal tip.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. The Most important thing to fix a saddle nose deformity is to establish structural integrity through structurally supportive grafts. This can be best done with open technique is my opinion . With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Paul M. Parker, MD, FACS · Answer

I prefer to correct a saddle nose deformity with a cartilage graft inserted and stabilized precisely with an open approach. This would also afford the opportunity to refine your nasal tip precisely. A carefully performed and closed open rhinoplasty incision should not affect your nostrils. I have found the vast majority of these columellar scars heal very well on my patients to the point where they are almost always inconspicuous.

Does surgery for saddle nose require special training? Is it better to do closed or open?

Answers (6)

More Rhinoplasty Questions

Long-Term Damage - could I have broken my nose if there was no bleeding, swelling or breathing issues?

Can I have my upper wisdom teeth removed 7 weeks after a rhinoplasty?

Can I reduce just the tip and have the procedure done without anesthesia? (Photos)

Is it possible to correct massive asymmetry in nostrils / lower cartilage following a septoplasty? (Photo)

What can be done to make my nose look naturally refined? (Photos)

Would a rhinoplasty help balance my features? (Photos)

WE SEND PRETTY
EMAILS