Would I be a good candidate for a closed rhinoplasty? (Photo)

Hi from Istanbul! A modest reduction can be performed in the bridge along with osteotomies to narrow it. If you're also considering making the tip smaller and slightly less projected, a tip plasty can be performed. These enhancements, aimed at refining and subtly altering the nose's appearance, can indeed be achieved through a closed rhinoplasty approach. For more detailed recommendations, an in person consultation is necessary. Best of luck to you!

An open or closed approach is just surgeon preference. A skilled, well-trained rhinoplasty surgeon should be able to provide adequate results with either an open or closed approach. I would recommend seeing a board-certified plastic surgeon (with a 6 year integrated plastic surgery residency and The Aesthetic Society accredited aesthetic fellowship) for a consultation. I would recommend a physical exam in person to further evaluate what is going on with the nose.

And "lowering" a bridge would depend more on the profile views. There may be other things to consider as well, if you're considering a rhinoplasty: a couple of the views seem to indicate that the tip cartilages stand out and their edges are visible, and that can be softened, if it's really an issue. These photos are all from one angle.

Then, why do you want a "closed" rhinoplasty? From where I sit, the best way to have a rhinoplasty is to find a surgeon who you think is most likely to hit a home run with your nose (based on seeing his photos, etc.) and then let him perform the operation however he thinks he will do the best job. Don't handicap him by suggesting a way for him to do the surgery. Between a closed and open rhinoplasty, the only thing the patient would even notice is the little incision across the columella, and if you've selected your surgeon well, and he decides to use the open technique, it might be very hard to even find the scar later on.

My two cents.

Then, some advice about what to do, and how much to do, in general:

How *much* to narrow the bridge, or lower the bridge, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

The answer to your question is that if you are a candidate for rhinoplasty overall, then you are a candidate for the closed approach. The fallacy that most surgeons preach is that in certain cases, ONLY the open approach is appropriate. However, I do ALL rhinoplasties closed, and have done so for many years now. There are many advantages to the closed approach overall. For patients, the healing process is dramatically quicker. In your case specifically, you have a nice nose already. From the photos, it is difficult to tell what bothers you about your nose. Nevertheless, you should seek out a rhinoplasty surgeon who does the closed approach (and does it often), whose photos you like. If you can have computer morphing done with the surgeon, it is helpful to know what might be possible to achieve with surgery. In cases like yours, where the goal of surgery is "finesse" changes, the closed approach really shines because the surgeon can see the results in real time on the operating table. Good luck!
Dr. B

Closed rhinoplasty can certainly give you some improvements to your nose, but a full set of facial photographs from all angles are required to make that determination about how best to proceed. With closed rhinoplasty, the incisions are located on the inside of the nose, and there's no external incisions. You will heal faster with closed rhinoplasty. Digital computer imaging from multiple angles would also be helpful in the education process.

I see nothing wrong with you getting a reduction rhinoplasty. The procedure can be done through either an open or closed approach.
Rhinoplasty surgery is fairly complex, and patients should be mindful of finding providers who have sufficient skill and experience. I usually recommend people have multiple in person consultations before choosing a provider.
Best,
Mats Hagstrom, MD.