Open Vs Closed Rhinoplasty to Fix Nose Hump?

I'm 17 years old and my nose has been bothering me forever. I am considering Rhinoplasty and based on what I have studied and read, open surgery will take MUCH longer to heal than closed surgery.

I just want to get the big hump removed and get the "bird beak" turned into a normal, straight nose. That's all and I don't think I want the front changed at all. Will an open surgery be needed for this and will my dream nose take a lot of drastic work to achieve? I prefer the truth. Thanks for the help. : )

Doctor Answers 25

Closed rhinoplasty and healing

A simple hump reduction can be treated with a closed rhinoplasty approach. The difference in healing between open versus closed rhinoplasty is not significant. The healing time in rhinoplasty has more to do with the extent of surgical changes that are done to your nose then the approach which is used to make those changes.
It appears from your photos that you do in fact have a hump on your nasal dorsum, however, it also appears that you may have some issues with a droopy tip and relatively poor tip support. I would suggest seeing a reputable rhinoplasty surgeon and ask their opinion regarding the changes you are seeking to your nose and how best to obtain them.

Chevy Chase Facial Plastic Surgeon
4.7 out of 5 stars 30 reviews

Open vs Closed is less important than having the right surgeon

Dear Lovexlinda,

I know that there is a lot of confusion between open and closed for people, but it is far more important to find the right surgeon whospecializes in rhinoplasty and is able to understand exactly what you want and is accomplished at achieving that. While some surgeons who do closed rhinoplasty believe that open causes more swelling, I can assure you that there are plenty of open rhinoplasty surgeons who will tell you that they see countless patients who have closed procedures that lead to swelling and scarring due to the surgeon being in the wrong plane when they are operating.

The point in closed vs open is that a good surgeon with experience will get you the result you want and that is the most important thing. You are seventeen and while swelling is important, it will go away either way. But you want to have a surgeon who specializes in rhinoplasty so that you have the right surgery the first time, so that long term you will be happy with your nose and not need any revisions.

The pictures you have are a bit small but one thing that I think you may need to consider is that if you just bring down the bump, you may find your nose looks a bit too long for your face. But that is something you can review when you are talking with your surgeon in consultation.

All the best.

Peyman Solieman, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Open vs Closed Rhinoplasty

Pick the surgeon, not the technique.  You are 17 years old - your most important consideration is picking a surgeon who will provide a good result which you'll enjoy the rest of your life. An extra week or two of post-operative swelling is not an important consideration. Select an experienced surgeon whose results you like.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Endonasal or external approach to the nose

Experienced rhinoplasty surgeons don't use the terms 'open' or 'closed'--both approaches involve incisions (endonasal may in fact be more destructive in some cases). In my experience, the external approach does not take much longer (if at all) in terms of recovery in this type of situation, and offers the advantage of superior results.

However, the technique used will depend on your discussion with your surgeon and his/her experience with each technique. Importantly, review results from that surgeon and make sure you communicate well with him/her.

Hope this helps.

Sam Most, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 64 reviews

Nasal hump reduction

An open versus a closed approach refers to the access used to perform the rhinoplasty. Most rhinoplasties can be performed via a closed approach. You are correct in that tip swelling takes longer to resolve with an open versus a closed approach. For something like a hump reduction, my preference is a closed approach since I reserve open approaches for revision rhinoplasties, significant tip alterations or grafting neither of which you would seem to need. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Open vs. Closed Nose Job

In my practice in Tampa, Florida, I see little difference in recovery time between an open rhinoplasty and closed rhinoplasty. The recovery time following a nose job is dependent on the amount of surgical dissection, cartilage repositioning, and bony work required, not necessarily on whether or not the nose was "opened." I agree with previous posts in that in addition to a dorsal hump reduction, you may also benefit from nasal tip rotation and increased projection. Many nose job surgeons prefer to perform nasal tip work through an open approach. More important than deciding on an open or closed approach is finding the right plastic surgeon. I recommend choosing a surgeon that you trust, has good before and after nose job photos, operates in an accredited facility, has experience in rhinoplasty surgery, and is certified by the American Board of Plastic Surgery. Jaime Perez, M.D. Nose Job Specialist in Tampa, Florida Plastic Surgery Center of Tampa, Florida

Jaime Perez, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 75 reviews

Open vs Closed Rhinoplasty for Hump Reduction

My first impression was that a closed rhinoplasty would work fine.  However, it looks like you may have poor tip support and require a columellar strut or tip graft.  This is best done with an open approach.

Daniel Reichner, MD
Newport Beach Plastic Surgeon
4.9 out of 5 stars 46 reviews

Open Rhinoplasty vs. Closed Rhinoplasty for Reduction of Nasal Bridge

O.K. - I think it's safe to say that you can get a good result with either an open or closed approach. You just need to interview a few nasal surgeons and find one whom you like and who appears to understand your concerns and can lay out a good surgical plan. If the best doctor happens to be someone who favors an external approach I wouldn't let it necessarily stop you from proceeding. I've used both approaches for several decades and the final result should be the same regardless of the approach with the exception that you will have a virtually imperceptible scare below the tip of your nose. Still it is ' your nose' and if you don't want that scar you will be able to find someone skilled who can get the job done without creating an external scar. Best of Luck

Jon F. Harrell, DO, FACS
Miami Plastic Surgeon
4.9 out of 5 stars 49 reviews

Open vs. Closed Rhinoplasty

In selecting a surgeon to perform your rhinoplasty, you should consider one with whom you feel the most confident in achieving the results that you desire. Leave the actual technique to this surgeon. Some rhinoplasty surgeons feel more comfortable and achieve better results performing an open rhinoplasty while some surgeons achieve better results with a closed rhinoplasty.

With the open rhinoplasty approach, the procedure tends to take a little longer, there is a little more bruising (and sometimes more bleeding), there is more prolong swelling of the nose, there is a scar that is sometimes more detectable than desired. Personally, I prefer the closed approach to rhinoplasty in 95% of my cases. I feel confident in this approach with my results being as good or usually better than with the open rhinoplasty approach.

My intra-operative judgment is better with this closed technique, the procedure takes less time and the swelling of the nose resolves faster. Judging from your pictures, you are an excellent candidate for achieving a nice cosmetic result that will address your desires and fit the contours of your face.

Sigmund L. Sattenspiel, MD
Freehold Facial Plastic Surgeon

Closed rhinoplasty for bridge reduction only and open rhinoplasty if tip work is desired

If your surgeon thinks that you only need reduction of the hump on the bridge of your nose, then a closed rhinoplasty will probably suffice. I find that most patients also benefit from adjustment of the tip such as refining the tip, decreasing tip projection (how far the tip projects from the face), and often times elevating the tip.

Tip work is generally more accurate with an open rhinoplasty. There will be slightly more swelling, but this is usually fairly subtle, and your nose will look immediately better when the splint is removed. Discuss the options with your plastic surgeon.

Michael D. Yates, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 10 reviews

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.