Do I need an open or closed rhinoplasty? (Photos)

Hello, and thank you for your question. Based on your photographs, you appear to be a strong candidate for rhinoplasty. In your case, I would likely recommend a closed (scarless) rhinoplasty approach, which can address concerns such as dorsal hump reduction, tip refinement, and subtle adjustments to tip projection and rotation — all without external incisions.

A closed approach, when appropriate, allows for precise structural refinement while minimizing visible signs of surgery. The exact plan would be tailored to your anatomy and goals, but with the right technique, you can achieve a very natural, balanced result.

I always recommend choosing a board-certified rhinoplasty specialist with extensive long-term before-and-after results, ideally shown with consistent lighting and angles. An in-person consultation is important to fully evaluate your anatomy and discuss the best surgical plan for you.

My preference is almost alway open. I can see what's going on, with the cartilages in their natural positions, and I can fine-tune the results much much better. The only difference between the open and the closed is that little scar across the columella, and it heals so well, in almost all cases, that I frequently can't even find it later, even if I *know* I put it there. So to me, it's all advantage and no disadvantage.
But you also need to make sure your surgeon can accomplish what you're looking for. Check his before and after photos, mainly. But don't worry about the open technique.

Based on your photos, you are a great candidate for rhinoplasty. The bump can be taken down and the tip deprojected and made smaller. In my opinion, an open procedure is the best way to do this because extremely precise maneuvers can be done with the nose open that are extremely hard to do with the nose closed. There isn't much of a difference in healing and the tiny incision in open rhinoplasty always heal very well. The main factor is what the surgeon is comfortable with, and how many rhinoplasties he/she does. Is a case done every week or just a few a year. A ton of experience will ensure a better result whether it's open or closed.

Hi
You cant really tell from just a side profile as to which type of rhinoplasty you require. What I can say is that it really depends on how much asymmetry you have and how bad your tip is. the more tip work that is required the more likely an open rhinoplasty would be better. If you only need a dorsal hump reduction and infractures then a closed technique is ok. Having said that most surgeons have moved towards doing open rhinoplasty as the results are more predicatable.
Cheers
Damien

Your rhinoplasty can be done either open or closed with a good result. Many surgeons do only one or the other. I order closed rhinoplasty

You have a dorsal hump that is both bony and cartilage. A closed rhinoplasty can be done with a file with the understanding that if that is inadequate or you have an open roof deformity or widening of the cartilage you will need an open rhinoplasty.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your question. You are an excellent candidate for rhinoplasty, open or closed based on your surgeon's preferences. I think it is one of the most beautifying surgeries that we do as plastic surgeons. A large portion of my practice is dedicated to rhinoplasty surgery. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey-haired plastic surgeon's sport. You should be able to have a beautiful result and would enhance your face dramatically. Best wishes to you.

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. Nasal tip deprojection is best done with open rhinoplasty in my opinion. This can be designed to have no visible scarring. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon