Wanted Open Rhino- Doc Performed Closed. Unhappy 1-Week Post-Op

I Had Rhinoplasty a Week Ago, my Plaster Has Been Taken off Today. I'm Quite Dissapointed to Find That Although the Nose Has tidied up a bit and does look better, all the major problems are still there. The surgeon gave me a choice between a closed rhinoplasty and an open, more precise one. I chose the open one because I wanted all the irregularities fixed. It turns out I definitely had a closed operation (no scar at the top of nose). I'm really confused why he did something completely different than agreed on. I also paid the price for an open rhinoplasty which was quite a bit more than for a closed one.

Doctor Answers 8

Open or Closed Rhinoplasty Results

At only one week after your procedure, it is early to judge a final result. None-the-less, it sounds like you have some concerns to discuss with your surgeon.  Do not be afraid to ask what techniques were used, how and why. I hope you end up with a result that pleases you and explanations from your surgeon that allay your concerns.

For other RealSelf readers out there, make sure before surgery that you communicate clearly with your surgeon what changes you want and get a clear answer as to how they will aim to achieve your requests. If your feel that you and your surgeon have a good rapport and communication, then the chances that your requests have been clearly recognized are increased. Good luck!

New York Plastic Surgeon
4.8 out of 5 stars 28 reviews

Open vs.Closed Rhinoplasty

This is certainly something I would bring up with the surgeon and discuss it sounds like you may not have been on the same page. I personally do at least 90% of my rhinoplasty procedures with an open rhinoplasty procedure. With over thirty years of experience I do believe that an open approach allows you a more exact and desired result and the revision rate is dramatically reduced. This is fully discussed with the patient and an informed consent of the procedure is always reviewed and signed by the patient prior to the procedure with the patients full knowledge of any procedure prior to surgery. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 210 reviews


You have raised several interesting issues.  Typically one week after surgery by any approach there is still residual swelling.  It is too early to judge the results.  Wait at least two more weeks before beginning to judge the results of your procedure.  Also, you should discuss your concerns with your surgeon.

Paul Carniol, MD
Summit Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Open vs closed rhinoplasty

An open rhinoplasty does not use an incision on the top of the nose, but actually at the bottom in the area called the columella.  As for being dissatisfied, you may want to give it some time to heal to assess the final result.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Open vs closed rhinoplasty

You are very early in the post op period and cannot make any judgements in the final outcome at this early date.  Discuss with the surgeon why he chose to do a closed technique vs the open one and if he felt that he was able to accomplish what you and he had in mind with the procedure.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 47 reviews

Dissatisfied with rhinoplasty

It's only been a week. You need to relax a little. There is a lot of swelling right now and you won't really start seeing the results for a couple more weeks. Call your doctor's office to ask for another appointment so you can discuss your concerns. The scar for an open approach is underneath the nose not on top. Good luck and hang in there.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 78 reviews

Open rhinoplasty scar placement

The open rhinoplasty external scar is on the columella.  You may easily have missed these sutures being removed during one of your visits as there are not many.  Ask your surgeon where the scar is and did he do an open technique.  Communicate your concerns about the appearance with your surgeon on your next visit. Best wishes.

Louise Ferland, MD
Richmond Plastic Surgeon
4.2 out of 5 stars 11 reviews


You may be looking at the wrong place. The open tip scar should be near the base of the columella not the top of the nose. Consult your surgeon on this.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 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.