What is a Closed Rhinoplasty?

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

Hello,In an open rhinoplasty you make an incision at the base of the nose that can inflict a scar. Most surgeons are more comfortable with the “open” rhinoplasty approach because it is easier for them to personally see the nose. In a closed rhinoplasty approach they make all of the incision 100% on the inside of the nose so no scars are made. If you are a primary nose with no previous surgery, you should ONLY consider closed scarless rhinoplasty (preferred by actresses and celebrities) because there is no risk of external scarring and much less healing and recovery time.  The goal is to finesse and enhance the nose without drastic change.  Meaningful refinement is the key.   All the same surgical maneuvers your nose requires can be performed with a skilled closed scarless surgeon.  All the best, Deepak Dugar, MDScarless Rhinoplasty ExpertBeverly Hills, CA 90210

The closed rhinoplasty involves performing the surgery entirely through incisions inside the nostril.  Open rhinoplasty involved an additional external incision across the columella, the strip of skin between the nostrils.  Each surgeon has his or her own preference.  I like the closed rhinoplasty but not all surgeons are experienced or trained in this technique.  The most important factor is not whether rhinoplasty is performed open or closed, but rather the skill and experience of the surgeon you choose.

Closed rhinoplasty is rhinoplasty which does not have an external incision on the nose.  In patients with the appropriate anatomy, closed rhinoplasty can offer quicker healing times and excellent aesthetic results.  Not all closed rhinoplasty(s) are the same, and there are a large amount of technique and surgeon dependent issues with closed rhinoplasty.  It is considered a lost art form amongst rhinoplasty and so be certain a surgeon has appropriate knowledge with closed rhinoplasty.

A closed rhinoplasty is when the surgeon uses hidden incisions inside the nostrils to correct the surgery, as opposed to external incisions in an open rhinoplasty.

Closed rhinoplasty refers to the nasal surgery techniques where all the incisions are placed inside the nose, thus invisible, while open rhinoplasty has some visible incisions, even though they usually heal quite nicely.  There is a debate among nasal surgeons as to the pro's and con's of each approach. 

In my hands I get  best results using a closed technique, as I believe you can get some finesse in the tip than with the open approach.  As you probably have learned by now rhinoplasty is one of the more difficult procedures for a surgeon to master.  Whatever the approach, make sure your surgeon is able to create a beautiful nose with nice proportions. In my practice we offer computer imaging to our prospective rhinoplasty patients, so that the goals and aspirations of the patients can be communicated. Of course not all surgeons that can created changes on the computer can produce those changes in the operating room. Pick you rhinoplasty surgeon carefully.

You might find it insightful to read my article "The Art of Sculpting the Nose" which can be found on my web site under "publications"
 

Endonasal rhinoplasty involves using incisions 'hidden' on the inside of the nose; however, if the flaring nostrils need to be addressed, external incisions are made.  There are some surgeons who only perform endonasal rhinoplasties and others who only perform open rhinoplasties.  For the right patient, one can use either technique to achieve an excellent result.  In general, you should not worry too much about what approach is used, rather you should feel extremely comfortable that the surgeon you have selected will achieve the result you desire.

A closed rhinoplasty is one where the incisions are all made inside the nostril. It is a good technique when minimal correction is needed. Simple crooked noses, isolated dorsal humps are examples where this approach can produce good results. Consult your surgeon to see if this may be a good option for you.

There are two approaches to rhinoplasty: open rhinoplasty and closed rhinoplasty. In closed rhinoplasty, all the incisision are placed on the inside of the nose and no external scars are visible. Open rhinoplasty uses the same incisions as closed rhinoplasty with the addition of a small incision across the undersurface of narrowest portion of the column of tissue between your nostrils. With time, this scar is virtually unrecognizable at conversational distances.
Many surgeons perform one or the other. However, most rhinoplasty specialists are skilled at both techniques will recommend the approach that they feel is most appropriate for you.

Rhinoplasty has been categorized into two main techniques: Closed and Open.
Closed Rhinoplasty
In the most basic sense closed Rhinoplasty (also referred to as minimal incision or incisionless) uses only hidden incisions inside the nose. Most, but not all ,surgical techniques are possible with this approach. It is the oldest of the two techniques, dating back over 50 years.
Open Rhinoplasty
Open Rhinoplasty means that a small incision is made at the base of the nose in the columella. This is the area that separates the two nostrils from each other. As a result, less incisions are made on the inside of the nose. Although this cut usually heals extremely well and can not be seen easily, there are times when the scar is visible. This technique has been around for a long time as well; about 30 years.
Choosing between Closed and Open Rhinoplasty Techniques
The choice between these two techniqes, for me, rests in how much grafting is needed in a particular patient. Because open rhinoplasty gives the surgeon increased visualization of the underlying nasal structures, it is often easier to place grafts and permanent sutures in order to restructure the nose. This can be a blessing if the nose requires extensive work with multiple grafts, such as in revision cases, or, for some surgeons, extreme nasal deviation.
However, this increased exposure does come at a certain price. Besides the potential for a visible incision, there is often increased swelling of the nasal tip and, potentially, an increase in the risk of long term skin changes.
I use predominantly closed rhinoplasty techniques (over 95%) for primary surgeries, deviated nose correction, and selected revision cases. I try to use as few grafts as possible, as they ultimately increase the complication rate. More importantly, I find that my results are more natural with this approach. The operation tends to focus on remodeling the nose, rather than restructuring it.
With all this in mind, the exact same operation and outcome can be achieved with either of these techniques. Each surgeon has a particular preference, based on comfort and experience, for using one technique versus another. In the end, if you like a surgeon's results and feel comfortable with him or her, then you will most likely be happy with the outcome of either technique.