Would a open or closed rhinoplasty be more suitable for me? (photos)

Question

I am interested in rhinoplasty and jawline liposuction with anaesthetic therapy. I have included “before-after” simulated images for your reference. Is open or closed rhinoplasty more suitable for me?

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.As far as I can see from your photo. I recommend you open Rhinoplasty.The open nose operation allows the surgeon to intervene better and minimizes the risks after surgery.It would be more convenient to decide with face-to-face consultation. Best regards!

Donald Groves, MD · Answer

Hello and thank you for your question. First let me say you did a great job with the manipulations to create the "after" images. It sounds like your main nose concern is the dorsal hump. Addressing the dorsal hump is one of the most common reasons people seek out and undergo a rhinoplasty. An open septorhinoplasty can best address the entire nose, and is particularly effective for addressing the issues you are concerned with. 
In addition to addressing your aesthetic concerns, your septal cartilage would be harvested (removed) and turned into multiple cartilage grafts, which would then be secured into different areas of your nose for structural support, to really reinforce the new shape of your nose and minimize changing/distortion due to healing/scarring. 
The open approach is very effective in facilitating complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look. Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery. That said, I would recommend only going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible. 
Regarding the anesthesia, my personal preference is similar to most- full general anesthesia to assure the most controlled environment and facilitate the best possible aesthetic results for such a complex procedure. Additionally, that would best facilitate the submental/jawline liposuction you mentioned, which could be done during the same operation. Everything ultimately comes down to surgeon and patient preference, so always have the conversation with your surgeon so you both know exactly what to expect, and so you both feel comfortable with how the procedure will be performed prior to proceeding. 
Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from photos and descriptions provided. I recommend for you to come see me or another plastic surgeon comfortable with rhinoplasty procedures for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps! 
Best wishes, 
Dr. Donald Groves 
Plastic Surgeon

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