Open rhinoplasty involves placement of incisions on both the inside and the outside of the nail. A closed rhinoplasty approach involves making all of the incisions on the inside of the to accomplish making the Cosmetic changes to the notes. There is no scarring with closed rhinoplasty since all of the incisions are placed on the inside of the nose. In our practice, we have seen many patients very unhappy with the open rhinoplasty scar across their columella. For more information and many examples of closed rhinoplasty, please see the video and the link below
I am a proponent of a closed Rhinoplasty technique, especially when it comes to Primary Rhinoplasty. The closed technique refers to the incision made inside of the nose. This surgical approach is much more challenging than the external approach but offers profound and significant benefits in so far as the early resolution of the swelling and its associated distortion.
The difference between an open rhinoplasty and a closed approach is the external scar across the columella with an open approach which is unnecessary with a closed approach. 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 (optolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California
This is a common concern for many patients. The decision is mostly surgeon preference with the only difference to you being a barely perceptible scar on your columella if executed properly. Great results can be obtained with either technique. I base my decision to perform one vs. the other on the complexity of the case. Feel free to watch my video for some examples and more information. Be sure the doctor you choose is a facial plastic surgeon or plastic surgeon. Good luck with your surgery!
More and more surgeons are choosing an open approach. The incision from open rhinoplasty heals beautifully >99% of the time. If your surgeon has confidence that open will be provide a better result, trust your surgeon. If you are picking between two surgeons - one that does open and one that does closed, trust your gut after reviewing results and meeting with the surgeons. Best of luck.
Generally, the scar should not be a consideration. It is extremely uncommon for the tiny scar(s) to be objectionable at all. The ability to predictable control/achieve the desired result is most important and outweighs the scar consideration. Whichever approach offers the predictability/control in the hands of your surgeon is the best approach.
Te choice between closed vs open rhinoplasty is the surgeon's decision. It shud be based upon the needs to attain the best results!
Thanks for sharing your concerns with us. I recommend you to send your photos to us to give you the advices you want and need, also to tell you what procedure you should perform. Kind regards
Some surgeons do their best technique in closed fashion. Others prefer open technique.Chose the doctor and not the operation
Once again I will suggest you pick the surgeon, not the technique. The most important consideration is achieving the best possible result.