I want a slight slope and upturned tip. Will a closed Rhinoplasty achieve my goals?

Will closed rhinoplasty achieve my goals of having s slight slope on brigde and slightly pushed up tip. I don't want a too upturned nose or a straight slope. I want to be able to smile and my nose not to look pointing downor drooping. I am a little skeptical of an open approach due to outside visible scar, uneven nostrils and hanging columella. What do you think is the best approach for me?

Doctor Answers 13

I want a slight slope and upturned tip. Will a closed Rhinoplasty achieve my goals?

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      I perform closed rhinoplasty on about 98% of the rhinoplasties I perform.  The tip and dorsum can be effectively manipulated through this approach with less scarring and swelling and reduced recovery time.  In addition, overall tip support is better and vascularity of the skin envelope is better.

Kenneth Hughes, MD

Los Angeles, CA

Not about the approach

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Whether done open or closed, the outcome of the surgery depends on the skill of the surgeon and realistic expectations.  You seem to have very specific goals.  You need an examination by a rhinoplasty surgeon who will be very honest with you about whether or not those goals can be met.  Elements of surgery such as skin thickness, cartilage thickness, and scar formation can affect the exact outcome.

Open vs closed rhinoplasty

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Both techniques can be used to accomplish the same goals.  The technique used depends on the experience of your surgeon.  As an advocate of the open approach, I like it because it allows better visualization and avoids the need for post operative packing.  It is my method of choice in all cases, but that does not mean that the closed technique is wrong or any less effective.  Having said that, the trend is for more and more surgeons going to the open approach.

I do not feel that the open approach is any more likely to lead to complications as you describe, and in nearly all cases, the tiny scar that is on the outside is hardly visable.

Howard A. Tobin, MD
Abilene Facial Plastic Surgeon

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Closed rhinoplasty

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Dear sunflowerslove,

  • With the open approach, we have more access to the tip and achieving symmetry
  • You can have uneven nostrils and a hanging columella from either approach
  • The incision, when closed carefully, should not leave much of a scar
  • See a rhinoplasty specialist to discuss your goals and you can decide the approach afterwards, there are pros and cons to both ways

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

Closed rhinoplasty for hanging columella and nasal hump

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Closed rhinoplasty techniques can accomplish all of your goals with regards to your  nose. The hump is composed of the bone and cartilage and can be shaved down. The tip can be lifted slightly. Releasing the depressor septi ligament will also help prevent the tip from drooping with animation. For many examples, please see  the link below  to our closed rhinoplasty photo gallery

Closed rhinoplasty for the droopy tip, hanging columella, etc.

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Closed rhinoplasty for the droopy tip, hanging columella, etc. can achieve your goals stated. Select an experienced rhinoplasty surgeon whose noses u like!

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Open vs closed

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The result you desire is obtainable with either approach - It is the skill of the surgeon performing your operation that will ultimately determine your final result

Dr Corbin

What approach would be best to correct my nose?

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  • I believe your nose could be approached through a closed or open technique depending on what you are trying to achieve with a rhinoplasty. Either approach can give you an excellent result. It is important however that you choose your plastic surgeon wisely. I would not exclude anyone on the basis of their recommended approach. It is important that you see patients photographs who had similar problems to yours and what results were achieved. It is important to be covered with your plastic surgeon and sometimes second opinions are advisable. Best wishes!

William G. Hart Jr., MD
Saint Louis Plastic Surgeon


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A closed rhinoplasty is one wya to perform the surgery. I prefer open to get the best exposure and to have precise control in treating the underlying structures.  

Closed or open rhinoplasty?

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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) 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 FACS

La Jolla, California

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.