Refine Nose Tip with Closed Rhinoplasty?

Question

Can the tip of the nose be refined with closed Rhinoplasty? Or does it have to be with an open Rhinoplatsy?

Deepak Raj Dugar, MD · Answer

Hello,All the same surgical maneuvers your nose requires can be performed with a skilled closed scarless surgeon. We perform refinement of the nasal tip through a scarless approach using endonasal techniques to size, shape and positioning of the nasal tip cartilages. All the best, Deepak Dugar, MDScarless Rhinoplasty ExpertBeverly Hills, CA 90210

C. Spencer Cochran, MD · Answer

Tip refinement can be accomplished with both open and closed rhinoplasty techniques. The question of which surgical approach to rhinoplasty is the "best" -- Open versus Closed -- is one of the most frequently debated topics among Rhinoplasty Specialists.

	Closed Rhinoplasty refers to a nose job that is performed via internal incisions - i.e., there are no external scars. The surgeon makes one or more incisions along the inside of the nose and lifts the skin up from the nasal framework. Once the skin is elevated, the shape of the nose is changed.

	Advantages:

	
		Potentially shorter operative time
	
		Less swelling of the tip
	
		No external scar


	Open Rhinoplasty, on the other hand, uses the same incisions as a closed rhinoplasty with the addition of an incision on the undersurface of the column of tissue that separates the nostrils called the columella. While this places a small scar on the exterior of the nose, in most cases, the incision heals very well and is not noticeable at conversational distances.

	Advantages:
	Better visualization for the surgeon
	Direct exposure of the anatomic structures
	More precise intraoperative diagnosis
	Less distortion of the nasal framework from intraoperative retraction
	Ideal for complex nasal deformities

	How do you know which approach is "best" for you? While you may have a preference for one or the other, your surgeon will recommend the approach that he or she feels is most appropriate, and the surgical technique employed depends primarily on the goals established by you and your surgeon. Some surgeons perform exclusively closed rhinoplasty while others prefer open rhinoplasty. There are surgeons who perform both types of rhinoplasty depending on the patient's needs.

David C. Pearson, MD · Answer

The short answer to your question is yes. A tip can often be refined through a closed approach, particularly if it's a primary rhinoplasty (meaning that it's not a revision surgery).

	For years, surgeons used to debate whether open or closed rhinoplasty was "better" for reshaping the nose, especially in terms of tip work. But for the most part now, reasonable surgeons agree that the best approach is the one that works best in that surgeon's hands. Some can get beautiful results with the closed approach. I tend to prefer the open approach. The only surgeon I would fault is the one who claims that there is only one proper approach to the nose.

Toby Mayer, MD · Answer

The closed method has been used for 75 years for tip refinement. The open approach we popularized in the late 70's is used when you are dealing with major tip asymmetry and need to sew in grafts etc. The surgeon's skill should be the point, not the type of procedure.

Ricardo Izquierdo, MD (retired) · Answer

Depending on the complexity of the problem, a closed approach (endo-nasal) can be used for a tip rhinoplasty.  I there are large asymmetries or irregularities, an open approach may be better suited.

Refine Nose Tip with Closed Rhinoplasty?

Answers (5)

Answer: Yes it is possible.

Answer: Yes it is possible.

Answer: It depends on the nature of the problem...

Answer: It depends on the nature of the problem...

Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

Refine Nose Tip with Closed Rhinoplasty?

Answers (5)

Answer: Yes it is possible.

Answer: Yes it is possible.

Answer: It depends on the nature of the problem...

Answer: It depends on the nature of the problem...

Browse related questions

Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.