What's the difference between open and closed surgery (rhinoplasty)? (Photo)

Closed Rhinoplasty is absent any visible external scars. Open has a visible scar across the columella of the nose which is permanent and visible. 

The
difference between an open and a closed rhinoplasty is the approach. Most
facial plastic and general plastic surgeons can perform either approach, and
the decision is informed by what type of reshaping maneuvers we're trying to
accomplish. Additionally, the open approach is preferred in patients who have
had nasal trauma or prior nasal surgery (where we anticipate an increase in the
technical difficulty of the procedure).
In a closed rhinoplasty the incisions are hidden inside the nostrils and all of
the work is performed through those incisions. There is no external (skin)
incision, so closed rhinoplasty carries the least risk for visible scarring.
Small to medium-sized hump reduction and many other rhinoplasty techniques may
be performed via a closed approach.
For me, to obtain the most control over the nasal tip for projection,
definition and symmetry, the open approach is the way to go. Think of it like
this: if you want to do technically precise work on the engine of a car, you'll
want to raise the hood (open rhinoplasty). The skin incision almost invariably
heals well, and for tip reshaping the control that you gain with the open
approach outweighs the risk of the skin incision.
Even more important than the type of procedure
is finding a Board-certified Facial Plastic Surgeon who you are comfortable
with, who you trust, and go with their fully-informed recommendation.