I want my nasal bridge to be flatter and the tip to be lifted. Can it be achieved with closed rhinoplasty? (Photo)

I don't have a bump on my nose but I want get my nose bridge to be slightly flatter and the tip of my nose to be lifted slightly. Can this be done with closed rhinoplasty or would the results be better with open rhinoplasty. The shape of my nose is the picture on the left and the shape of nose I want is on the right

Doctor Answers 9

Can a closed rhinoplasty achieve the results I desire?

A closed rhinoplasty refers to a technique of cosmetic nasal surgery in which the operation is performed through small incisions placed inside the nostrils, with no incisions on the outside of the nose. This was the standard technique for many years, but requires an excellent understanding of anatomy as the surgical field is always covered by skin during the surgery. In the open rhinoplasty technique the skin of the nose is dissected back from the tip and top of the nose, but this requires making an incision in the skin of the nose between the nostrils. However, the visualizing of the anatomy during the procedure allows the surgeon to identify the smallest anatomic detail and adjust their technique accordingly. The trade-off of a very small incision hidden under the nose for the accuracy of correcting each and every anatomic asymmetry makes the open technique the most popular rhinoplasty technique used today.Although the results you desire can be achieved using a closed rhinoplasty technique, the results are often more predictably achieved using an open technique.

Grand Rapids Plastic Surgeon
4.8 out of 5 stars 26 reviews

I want my nasal bridge to be flatter and the tip to be lifted. Can it be achieved with closed rhinoplasty?

Hello jessa11,Thanks for your question.  Yes, a closed rhinoplasty can be used to achieve your ideal nose.  The procedure you are looking for involves a mild bridge reduction and a mild shortening of the caudal edge of the septum.  If the bridge appears wide after reshaping, then osteotomies (nasal bone reshaping) can be performed to optimize the view from the front.  I would recommend that you consult with a rhinoplasty specialist in your area for more information.Good luck,Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 56 reviews

Open vs Closed Rhinoplasty

Your goals are very realistic and can be achieved with either an open or closed technique. Every time I'm asked this question in this forum I always recommend the patient choose an experienced rhinoplasty specialist, not the technique. You want a surgeon who will give you a natural non-surgical appearance.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Open vs. closed rhinoplasty?

Both open or closed rhinoplasty can give excellent results. It depends more on the skill level of the surgeon more than the approach. See a very experienced rhinoplasty surgeon who's noses look like what you would like to have done to yours and not the overdone look.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews


You can have this procedure performed either way.  Surgeons that prefer an open approach emphasize that the improved exposure allows for more control of tip and bridge shape.  I would not be so concerned about the open vs closed debate since the columellar scar heals very nicely and is hardly noticeable.  Best wishes, Dr. T. 

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 52 reviews


Yes, that is possible. You need to have the dorsum taken down a bit as well. Best of luck with your decision to move forward.

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

Open or closed rhinoplasty?

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 the Canadian Society for Aesthetic Plastic Surgery (CSAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla,California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews


Hello and thank you for your question. Based on your photograph, you may benefit from a tip 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 cephalic rotation of your tip to turn up your tip slightly and a tip de-projection to make your overall nose smaller. The most important aspect is to find a surgeon you are comfortable with. 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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 131 reviews

Open vs. Closed


In your case both open and closed techniques would be acceptable. It all depends on which technique your surgeon is comfortable with. Most experienced rhinoplasty surgeons should be comfortable with both techniques. 



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 274 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.