Open Rhinoplasty, Does Surgeon Know What Needs to Be Done Before Hand?

Hi. When a surgeon performs an open rhinoplasty does he know what he is going to do before he starts? Or does he need to have opened the nose to see what procedures are necessary for the desired outcome? Should the patient be informed in detail of what all took place during the procedure?

Doctor Answers 11

Open rhinoplasty strategy

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A good, accomplished  plastic surgeon will have a plan before he/she opens the nose.  Executing the plan is the goal.  Like any plan, there are always things that require experience and an ability to react to adversity or the unexpected.  In fact, the unexpected is expected.  This is why you chose the best.

Talmage Raine MD FACS

Chicago Plastic Surgeon

Surgeon's Plan for Rhinoplasty

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Yes, the most important part of rhinoplasty is for the surgeon to know the diagnosis as well as the desires of the patient so the plan can be executed properly. During surgery, the surgeon is able to gain a more accurate understanding of the issues at hand and may need to make additional changes to achieve the best result. When the surgery is complete, the patient has the right to know what was done by the surgeon to try to fulfill all goals of the surgery.


Jaime Perez, MD
Rhinoplasty Specialist
Plastic Surgery Center of Tampa

Jaime Perez, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 81 reviews

Open Rhinoplasty, Does Surgeon Know What Needs to Be Done Before Hand?

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 IMHO Rhinoplasty Surgeons should have a well thought out technical plan as well as an aesthetic plan before beginning the Rhinoplasty.  Part of the Rhinoplasty consultation is for the Rhinoplasty Surgeon to convey this information to the patient.  If there are any questions as to what type of grafting material was used previously or whether or not one was used at all, these should be addressed during the consultation with the appropriate plans made jointly (surgeon and patient) as to how any of the possible outcomes would be handled.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Open rhinoplasty is best because of the unexpected.

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I like the open rhinoplasty because occasionally, the unexpected is discovered and the operative plan of a closed rhinoplasty might not be proper.  The patient is entitled to the operative note which discloses in detail what the surgeon did in the operation room.

Open Rhinoplasty, Does Surgeon Know What Needs to Be Done Before Hand?

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External (open) rhinoplasty allows more predictable rhinoplasty results, in my opinion. The advantages lie in being able to directly see the cartilages that are being modified and the ability to easily place sutures to reshape the nasal tip. With that said, the surgical plan should be set before beginning either an external or endonasal rhinoplasty. If a plastic surgeon is expecting the external rhinoplasty view to give them inspiration for what maneuvers need to be performed, then the game has already been lost. I hope this information is helpful.

Stephen Weber MD, FACS

Rhinoplasty Surgery

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Generally after a detailed examination of your nose (inside and outside), your surgeon will form a plan to achieve the results you seek before surgery.  I generally have several thorough discussions with my patients with a clear plan for surgery before going to the operating room.  Sometimes, particularly in revision rhinoplasty, modifications of the original plan to achieve the results that were discussed may be needed.  Please consult with a board certified specialist who can help you achieve the results you seek.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews


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Before any rhinoplasty surgery the surgeon needs to perform a detailed examination of the nose, take appropriate nasal measurements and plan the surgical procedure before surgery. Opening the nose and deciding what today at that time lengthens the surgery time and makes the results of surgery less reliable. Once you inject the nose and open it everything is changed from its normal resting state so measurements and alignments during surgery may be off.

After surgery it is the patients right to know what was done at whatever level of detail they request.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon


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In general, a surgical plan is created before taking someone into the operating room. It does not mean that it may be modified during the surgery.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Planning for Open Rhinoplasty

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If you surgeon does not know what he is going to do before an open rhinoplasty you need to find another surgeon. The main advantages of the open technique, which I have used for over 25 years, are that the surgeon has more control and the results are more predictable. After surgery the details of the operation should be given to the patient if desired.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

The Surgeon Should Plan The Rhinoplasty In Advance

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Dear Jenna,

An accomplished surgeon plans his/her surgery in advance based on thorough examinations and assessment of the patient.

With that perspective, it is not uncommon that during the surgery some aspects of the procedure will be unveiled and dealt with accordingly.

Furthermore, communicating with the patient is very important to be able to translate what the patient likes to accomplish surgically considering the variables from one patient to another.

However, the main goal remains to provide the best NATURAL-LOOKING results that will complement the patient's facial features.

That being said, please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of additional corrective surgeries dramatically.

I hope this helps and please feel free to check the website below.

Thank you for your inquiry.
The best of luck to you.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 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.