Open or closed rhinoplasty? (photos)

I want to get rid of that bump in mu nose, make my nostrils a little bit smaller and get a more defined tip. Which option will you choose for me, open or closed?

Doctor Answers 8

Open or closed rhinoplasty?

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Excellent cosmetic results can be achieved with both techniques. There is not a best way to perform the procedure. Individual surgeons have their own preferences of how to produce the best results in their hands. What is more important than whether a closed or open approach is utilized is the experience and artistry of the plastic surgeon and your comfort level and confidence in that individual.

Following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on limited 2 dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the operative procedure would not be in your best interest. I would suggest you find a plastic surgeon with extensive nasal surgery experience who is certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon 9otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Open or closed rhinoplasty?

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   If the skill is there, anything can be done with a closed approach.

Kenneth Hughes, MD

Los Angeles, CA

Open vs. closed

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Surgeons prefer either closed or open approaches based on experience and training.  I believe with either technique you can obtain your desired results.  Tip work and asymmetry can generally be better assessed and corrected with an open approach.  Also larger dorsal reductions are easier to perform with the better exposure provided with the open approach. 

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Closed or open rhinoplasty

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Mostly rhinoplasty can be performed through  a close approach,  the open rhinoplasty is prefered  either for  the treating of a secundary rhinoplasty or  a round (bulbous) tip. Neither of them is your case, however some particular conditions may influence the surgeon  when  he is choosing  the more convenient approach  in each  singular case so an in -person consultation is required.

Jose Luis Acosta Collado, MD
Dominican Republic Plastic Surgeon

Open versus closed rhinoplasty debate

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Hi Daniel,

On balance open rhinoplasty would be your best option.

Closed rhinoplasty (where all the incisions are made inside the nostrils so none are visible) has the advantage of being quick and with a relatively quick recovery and a lesser time frame for swelling to come down. However open rhinoplasty (where there is an incision across the columella - the piece of skin between the nostrils - which then joins up with the same incisions as closed rhinoplasty inside the nostrils) has the great advantage of being much more accurate in achieving a reliable result.

Open rhinoplasty allows the surgeon to visualise the bone and cartilages of the nose directly so it is much easier to accurately modify these structures by either adding or subtracting or bending these structures as desired to produce a more beautiful outcome.

Open or closed rhinoplasty?

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Determining if the procedure can be done open or closed depends on many factors usually clarified during an in-person consultation, where a review of your medical history (including nasal breathing issues) and a thorough examination would be performed.  However, commonly removing a bump and narrowing of the nostrils can be performed using a closed rhinoplasty technique.  

I hope this helps. 

Timothy R. Miller, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 70 reviews

Based on your photo, well-performed rhinoplasty surgery may lead to a more feminine and pleasing nasal appearance.

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In our practice, all rhinoplasty procedures are performed with an open approach. You may benefit from consulting several reputable rhinoplasty specialists so you can see what might be best for you.

Hope this helps you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 429 reviews

closed rhinoplasty candidate

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  Both open and close rhinoplasty techniques can give you the desired result as long as you choose an experienced rhinoplasty surgeon. From the photographs, it appears you desire to have a hump removed and narrow the tip and bridge.

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.