Closed rhinoplasty, also called endonasal rhinoplasty, involves incisions placed inside the nose. There are no visible external incisions in this approach. Open rhinoplasty, sometimes called external rhinoplasty, involves a tiny, inverted-V shaped incision being created in the columella, between the nostrils. If performed carefully and with attention to detail, this incision heals beautifully and nearly invisibly for the vast majority of patients. This approach allows the surgeon to see the tip (lower lateral) cartilages directly, in their natural shape and location, while reshaping them. The overall recovery experience is quite similar for both types of surgery, with the exception being that in the open approach, a handful of very fine stitches are removed 6-7 days after surgery.
In my San Francisco Bay Area practice, I perform both open and closed rhinoplasty and it is the patient's nose and aesthetic desires which steer my decision regarding which approach to use. If there is significant work to be done at the tip, an open approach is preferable, in my experience. If it is simply a matter of shaving down a hump along the bridge or straightening a curved nose, these can easily be achieved through a closed approach. Let your surgeon guide you regarding which approach they prefer, based on your unique anatomy, aesthetic sense, and the surgeon's training and experience.
Regards,
Dr. Mehta