What Are the Advantages of Closed Revision Rhinoplasty Versus Open Revision Rhinoplasty?

Doctor Answers 7

Depends on the skill of the surgeon

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Open vs Closed is a large argument between rhinoplastic surgeons. I do 95% of surgeries closed - but then again, I have been doing noses over 35 years. On occasion, I will do it open if it is very complicated, otherwise I do it closed.

Advantages of Closed vs Open Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The main advantage of a closed rhinoplasty is that recovery is a little quicker. However, after doing open rhinoplasty for 35 years, there are advantages to this technique in certain patients. In difficult or revision rhinoplasty procedures, the surgeon has more control and results are more predictable. I prefer the open procedure when grafts are necessary, when the patient presents with difficult tip problems, and with most revision surgery.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Closed versus open revision rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The method chosen depends upon the severity of the deformity.  In general, only minor, focal deformities are amenable to closed revisions while the majority will require an open approach.  The open approach allows greater visibility and easier cartilage grafting.

William D. Losquadro, MD
Westchester Facial Plastic Surgeon
4.9 out of 5 stars 30 reviews

You might also like...

Closed vs open rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Closed rhinoplasty has less tissue dissection and may have less swelling post op. The question is more what result you are looking for and if the surgeon feels comfortable that he can achieve that result with this approach. If he/she is more comfortable with an open approach and thinks it will be a more predictable result then follow his recommendation.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

What Are the Advantages of Closed Revision Rhinoplasty Versus Open Revision Rhinoplasty?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Closed Rhinoplasty heals quicker because it has less tissue dissection but the flip side is it also has less ability to deal with serious nasal tip asymmetries/deformities than Open Rhinoplasty.

Non-surgical techniques are helpful for revision rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Whether a surgeon choses open or closed techniques for revision depends largely on the surgeon's, training, experience, and preference.  The open approach allows for direct vision and easier placement of grafts.  The closed approach has the advantage of disrupting less of the scar tissue and skin which may be helpful in certain instances.

Another great option to consider is using dermafillers for revision rhinoplasty.  Dermafillers are excellent at achieving excellent contour results.  Non-surgical rhinoplasty techniques for revision also avoids much of the trauma and therefore some of the risks involved with revision rhinoplasty.

The fillers last 6-9 months, but there is often a cumulative effect from having the skin supported over time.  The results tend to last longer and longer and there are times when a permanent filler like ArteFill may be used.

Open vs closed revision rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The adavntage of the open technique is direct vision, precision, and the ability to suture stabilize the anatomy, grafts etc.  Most rhinoplasty experts would advocate that most revisions be done open.  There are some exceptions but that would be the most common approach I believe.

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.