I want a slight slope and upturned tip. Will a closed Rhinoplasty achieve my goals?
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
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
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.
- 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
Closed rhinoplasty for hanging columella and nasal hump
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.
Closed rhinoplasty for the droopy tip, hanging columella, etc. can achieve your goals stated. Select an experienced rhinoplasty surgeon whose noses u like!
Open vs closed
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
What approach would be best to correct my nose?
- 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!
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?
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