An open rhinoplasty is where you make an incision on the bottom part of the nose called the columella and it's lifted in order to gain a wide exposure to the anatomy of the nose, giving more access to certain anatomical regions of the nose. But there has some complications with it in addition to the scarring, long term swelling, irregularities. It's a good approach for many surgeons, but in my hands I prefer the closed rhinoplasty because of the advantage of minimal to no scarring and less swelling and downtime.
Is a Open or Closed Rhinoplasty More Effective?
Dr. Arthur Handal explains both an open and closed approach to a rhinoplasty and which is more effective, in his opinion.