Open or Closed Rhinoplasty for Making Entire Nose Smaller?

The approach your surgeon chooses with which to perform your rhinoplasty would be based on the surgeons comfort level with open or endonasal rhinoplasty in particular situations. I use both approaches and continue to use open rhinoplasty in particularly difficult or revision noses. In terms of healing, it may be that more difficult cases are performed with an open technique and the amount of steps used to complete the rhinoplasty has more to do with prolonged healing rather than if the rhinoplasty is performed open or using an endonasal approach.

Shun
I would agree with the others that have weighed in, specifically it is the skill and the preference of the surgeon that determines external vs endonasal rhinoplasty. And the issue of short term healing is relatively insignificant, since the focus is on a surgical result that will last a lifetime. And as all rhinoplasty surgeons will tell you, it takes a year or more for final results.
I want to bring up another point however. If you are truly decreasing your profile by a centimeter, that will take a long time for the skin/soft tissue envelope to contract down to the new structural height. In fact, that is likely to become the true limitation to your surgical result. That's a lot of change! Sometimes the skin does not have that kind of elasticity, or fails to show the defined qualities your surgeon created in the framework. So you may be advised to keep a little more overall size, but improve the balance, which would give you a better shot at creating the definition and refinement of an appropriate result.

The experience and preference of your surgeon should guide you in making this decision. I perform nearly all of my Rhinoplasty Surgeries with an open approach. Rhinoplasty Surgery rarely exceeds 2 hours, and downtime is only 10-14 days. By 3 weeks after surgery 90% of your swelling is gone, and it will be tough to tell that surgery was performed. Patient satisfaction is very high.
I prefer the open approach since visualization of your septum, bridge and tip is luxurious, and I feel it allows me to accurately reconstruct and modify these structures to obtain a desired result.
I've attached a link to my Rhinoplasty photos for your perusal.
I hope this is helpful for you.

Hi Shun,
I hope that your nose is very large to start with because a 1 cm reduction "all around from base to tip" is quite a bit of trimming.
Skilled surgeons should be able to accomplish your goals with either approach, but for a large amount of reduction I prefer to use an open approach .
Choose your surgeon carefully, but not on the approach.
Good luck and be well.
Dr. P

In my hands, the majority of the rhinoplasties can be performed closed, and I believe the recovery is quicker.

While I do perform open rhinoplasties, they are reserved for special cases and have prolonged swelling.