Would an Open or Closed Approach Be Best for Me? (photo)

My nose was knocked when I was 16, and I had septoplasty to improve my breathing a few years after that, but now that the swelling has fully subsided (I am 21), my nose looks more crooked than before. Which rhinoplasty approach would you advise on a crooked nose like mine? I am reluctant to get open rhinoplasty and would prefer closed, but would open work better in my case? Thank you

Doctor Answers 9

Open versus closed rhinoplasty

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Dear seattlesporty,

  1. The answer all depends on what the surgeon does to get his/her best results
  2. In my experience I like the open approach for twisted and crooked noses because I can place cartilage grafts precisely and sew them in place
  3. Straightening a crooked nose to be perfectly straight is challenging, so go with who you think is best, rather than the approach they use - healing is temporary, results are permanent

Best regards,

Nima Shemirani

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

Open vs closed

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Seattlesporty, There is no "correct" approach. I use an open approach on almost all of the revisions I do of other physicians rhinoplasties and I use a closed approach on the majority of my virgin rhinoplasties. In my experience the major disadvantage of an open approach is the tendency for the patient to retain edema (swelling) for a longer time than a closed approach. The incision itself has never been an issue in 25 years of practice. As usual, see several rhinoplasty specialists, look at lots of photos and choose one that you like. Good luck!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 52 reviews

Open or closed rhinoplasty?

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For me, I prefer an open approach for most patients because I feel that I have the best exposure and visualization of the structures to repair. But if a surgeon feels comfortable doing it close then that is fine as well.

It's not about open or closed rhinoplasty but the skill of the surgeon and what gives them the best results that matter most

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The argument about open vs. closed rhinoplasty has basically been put to rest at medical meetings and rhinoplasty courses. Surgeons have their preferences. Equally good results can be achieved by either approach. Open, however, has a tiny almost imperceptible scar across the bottom of the nose.

For my practice, I perform about 80% primary rhinoplasties using the closed approach. My personal indications for an open approach are: very crooked nose, very short nose that needs the tip to be brought down and extremely large noses that need significant reduction in top projection (bringing the tip closer to the face).


Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 134 reviews

Would an Open or Closed Approach Be Best for Me?

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The experience of the chosen surgeon dictates which approach will be used and the degree of deviation of the nose effects that decision. In my opinion an open might offer a better option but I have done closed repairs with very good outcomes. 

Open or closed rhinoplasty for revision crooked nose.

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Open or closed rhinoplasty for revision crooked nose is a common question. I have used both for 35 years and I have to see the nose to dteine which I use. See a very experienced revision rhinoplasty surgeon who does good noses by either method. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Would an Open or Closed Approach Be Best for Me?

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             I perform almost exclusively closed rhinoplasties, but the result will depend upon the expertise of the surgeon.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

closed rhinoplasty approach for crooked nose

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 More important than an open or closed technique decision is the experience  of the rhinoplasty surgeon performing the procedure.  The experience of the surgeon will get you to your goal of a straight nose through their preference of either open or closed techniques. Your nose can be performed through close  rhinoplasty technique if performed in our office. Please see our closed rhinoplasty photo gallery below.

Open or closed approach

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Good results can be optained with either approach depending on the surgeon.  I personally prefer the open approach if significant work is required since this allows me to more easily see and correct the problem.  The most important thing is to choose a surgeon who is well trained in rhinoplasty.   Donald R. Nunn MD  Atlanta Plastic Surgeon.

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.