The debate regarding the approach (open vs. closed) for rhinoplasty is and old one that really has no relevance with regards to results. There are many excellent surgeons that perform one or the other or both. The conversation with regards to the operation should be about cartilage and bone management techniques and other nuances that will impact the result in a more profound way. I recommend seeking the opinion of a surgeon who is well versed with the operation, performs it frequently, has good word of mouth and has good before/after photos.
Best of Luck,
... But the technique is far less important than the skill of the surgeon. If the surgeon can prove to you that he can make the changes you are seeking, let him use the technique he's best with.
See the "Web reference" link, just below my response. I made a couple computer morphs, and animations of the morphs, to show the changes that are possible for your nose in truly expert hands.
I elevated the tip of your nose, took down the bump, narrowed the bridge a little bit. If you only have the bump taken down, I'm worried your nose will look too long. Noses tend to look longer if a bump is removed, so we often elevate the tip to offset that effect.
You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle. Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon.
While this is a common question, what matters most is that you have a surgeon that understands your wishes and can deliver as perfect a result as possible. There are pros and cons to each approach and I wouldn't base your selection on "open" vs. "closed" alone. You have a great starting point, and should get a great result. Good luck!
You have very attractive features and an aggressive rhinoplasty my have adverse effect on the other features. On the other hand, leaving flaws behind may have a similar effect. It is hard to judge from the limited photos but a slightly narrower tip, narrower mid portion of the nose and minimally shorter nose may take away the ill effects of the nose on the other features and reveal your pleasing features more. You may want to consult someone who has sufficient experience with rhinoplasty since the margin of error on your nose is very small.
A conservative rhinoplasty sounds like the right procedure for you. Depending upon what you desire for th remainder of the nose.
Good results can be obtained in many primary rhinoplasties with either a closed or open technique based on the surgeon's experience and preference. As a general rule, the more limited the nose changes (e.g., bump reduction) the more likely a closed rhinoplasty can be successfully used.
A rhinoplasty to remove the small hump and narrow your wide bridge can be achieved with a closed procedure. Consult with a rhinoplasty specialist so you achieve a natural result with subtle changes.
The open versus closed approach is just that, It is only the approach to get inside the nose. Cartilage removal, cartilage grafting techniques, tip- plasty surgery, dorsal hump removal, and osteotomies can all be performed with either open or closed approach. The closed approach avoids the visible incision across the columella. For more information and many examples, please see the link below to our closed rhinoplasty photo gallery
The difference between an open rhinoplasty and a closed
approach is the external scar across the columella with an open approach which
is unnecessary with a closed approach. 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 (optolaryngologist) that you trust and are
comfortable with. You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
Hello and thank you for your question. Based on your photograph, you may benefit from a tip narrowing and refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Cartilage grafts may also be used to help improve tip refinement. You may also benefit from a conservative dorsal hump reduction. These techniques can both be performed via an open or closed approach. My best advice is to choose a surgeon you trust and do whatever technique he/she is more comfortable with for your particular nose. The care and skill of the surgeon is much more important than whether they are performing closed vs open. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon