Open or closed rhinoplasty? (photos)

Some surgeons said to me that i need an open rhnoplasty and others closed. I had a septoplasty and turbinectomy a few years ago (endoscopy). This time i need a sinus procedure and may be re do the turbinectomy. Thanks for your suggestions!

Doctor Answers 15

Open versus Closed Rhinoplasty surgery

Beware the surgeon that only use one surgical technique!  If you go to a surgeon who will only do your note open it may be that you are going through unnecessary surgery. Judging from your pictures you would do very well with a closed rhinoplasty technique. You have a bump, and your nose is over projected. These two things can easily be taken care of with a closed rhinoplasty technique. Do your homework pick a qualified surgeon. Look at his before and after pictures. Ask him many questions particularly if he wants to do your nose open and does not allow you to have a closed surgical technique.

Miami Facial Plastic Surgeon
4.9 out of 5 stars 60 reviews

Liposuction: How long can both procedures take to get done on the same exact day?

Surgeon's preference for primary rhinoplasty. Your surgeon should be certified by the American Board of Plastic Surgery or the American Board of Facial Plastic Surgery. That's why it's so important that you be able to see allot of photos before and after. You want to be able to urge the whole of the work. I make a comparison to baseball. Think about this. Would you rather have a player on your team that hits a home run once in awhile or one that has a consistent average? There are some excellent facial plastic surgeons as there are plastic surgeons who do beautiful nasal work. When it comes to your nose, it's is imperative that you research as much as you possibly can before making your decision. This is your face and there no covering it up.

I wish you the best on your journey. I hope that the info provided has been helpful. Should you require any further clarification, do not hesitate to contact us. I personally conduct all the consultations and formulate an individual operative plan based on physical findings. We are one of only a few in South Florida that employ a web based program called TouchMD. Through this program potential patients from as far away as California can upload their photos. I then review each and everyone and draw my recommendations on your actual picture. This info is made available to you with the use of a private password that only you will have. TouchMD is private and follows all applicable privacy laws (HIPPA). I answer all questions personally, not through patient coordinators or other marketing individuals.

Good luck, Dr PG

Closed or Open Approach

The approach does not matter for a primary rhinoplasty i.e., first time nose job. It is more to do with the surgeon's comfort level with the approach and their competence. RegardsDr. J

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 89 reviews

Open or Closed Rhinoplasty

Although you may have read or been told that there is some particular advantage to the approach in a Rhinoplasty, this is really the wrong way to go about choosing a Surgeon.  Nobody "needs" an open or closed Rhinoplasty.  Some Surgeons prefer the closed approach, some the open approach, and some will do either based on the circumstances.  What is most important is the experience and results of the Surgeon.  It's very simple:  choose a Surgeon whose results you like, who specializes in Rhinoplasty and who performs a lot of Rhinoplasty. 

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 81 reviews

Closed rhinoplasty approach for dorsal hump removal

  A closed rhinoplasty approach can accomplish making all the required changes in the nose such as a dorsal hump removal, decreasing the projection of the nose,  and spreader graft placement. The only difference between the open and closed approach is the incision across the columella. for more information in many examples, please see the video and the link below to our closed rhinoplasty photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Open or closed rhinoplasty?

Hello, and thank you for the question. Performing rhinoplasty using an open technique allows the surgeon to get a better look inside the nose. In general, this approach is used for more complex procedures. A closed approach may be adequate depending on the patient's needs. The procedure is tailored to the patient's goals and what he or she would like to accomplish with the surgery. An in-person consult would be best to obtain the most accurate advice on technique. During a consultation, computer imaging software may be used to morph a photo of you. This will give you an idea of how the final result of surgery may appear. It also serves as a fantastic communication tool between you and your prospective surgeon. I hope this information helps, and I wish you the best of luck. 

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 44 reviews

Open vs. Closed rhinoplasty

Thanks for your question. The short answer is that it kind of depends on what your goals are. Your goals combine with your surgeon's skills to make an operative plan. Some surgeons elect to do certain things through an open technique; others prefer a closed technique. From what I see in your nose, you'd probably get an open rhinoplasty from me because you will need quite a bit of grafting to prevent problems down the road and to balance out your nose; I prefer to do this through an open approach. Honestly, the main difference is just a scar across the base of your nose. That scar fades to nothing in a few months. You would have a longer recovery in terms of swelling of your nasal skin with an open approach, but that's temporary too. The more important thing is to pick an experienced surgeon who you're comfortable with. Then just trust their judgement on whether you need an open or closed approach. Good luck!

Robert S. Schmidt, MD
College Station Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Open or closed rhinoplasty

May patients seeking rhinoplasty are faced with the question of whether to pursue an open or closed rhinoplasty. There are talented surgeons who perform rhinoplasty open and just as many who perform it closed. The only difference is the cut along the bottom of the nose. With good technique, the incision can be almost invisible by 2 months. It's more important to select a surgeon who is on the same page as you regarding your goals. I like to use computer simulation to make sure my patient and I are communicating clearly before we go to the operating room. Safety comes first. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Open or closed rhinoplasty?

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 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 (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

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Open versus closed

This question has plagued our specialty society for decades.  At the end of the day, I leave the decision of whether to open when I feel I need better visualization or if the nose is traumatized from prior surgery.  Depending on what you do not like about your nose will also dictate the approach.  Please seek the advice of a double board certified facial plastic and reconstructive surgeon.  Good luck!

Roberto E. Garcia, MD, FACS
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

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.