What's a better method for a very long, hooked, bulbous, Italian nose; closed or open Rhinoplasty?

 The debate about open rhinoplasty versus closed rhinoplasty is only  about the approach to the surgery, not the surgery itself.  With closed rhinoplasty, all the incisions are completely located on the inside of the nose.  No external incisions are required. Addressing the bulbous tip, large hump, hooked and long nose can all be addressed through either closed or open rhinoplasty. We perform closed rhinoplasty. For many examples, please see our closed rhinoplasty photo gallery.

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  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 (ENT)  that you trust and are comfortable with.
You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California