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Plastic Surgery Blog

Open vs. Closed Rhinoplasty: What You Need to Know

Open vs closed rhinoplasty – what’s better for you? Like with many critical decisions, the honest answer is, “It depends.”

So, what does it depend on, you ask? Your specific needs and your doctor’s clinical advice will be major factors in the decision. Certain modifications of the nose lend themselves to one approach over the other. Let’s take a closer look to help sort all it out.

Open rhinoplasty is a nose job performed with an incision made through the bridge of the nose or the tissue between the nostrils.  It’s called “open” because, during the procedure, the skin of the nose is folded upward to reveal the cartilage and other structures underneath. Conversely, a closed rhinoplasty procedure does not involve an incision through the bridge. Instead, the whole operation is performed by your doctor through the nostrils.

Are You Qualified for Rhinoplasty Surgery?

Before deciding between open vs. closed rhinoplasty, the first thing you’ll want to do is ensure you’re a good candidate to have a so-called “nose job” procedure.

The basic point of any rhinoplasty surgery is to change the shape or size of the nose, whether to bring it into harmony with the rest of the face or to correct aesthetic issues such as bulbousness, a hooked tip, etc.

Generally speaking, the best candidates for rhinoplasty are looking to make modest changes to the appearance of their nose. Additionally:

  • They are in good physical health overall.
  • They are not smokers.
  • They do not have any conditions that would impede them from proper healing.
  • They have talked with a plastic surgeon and have realistic expectations about rhinoplasty (including expectations about the outcome as well as the recovery time).

If you fit the above criteria, you may be an ideal candidate to have a nose job… which returns us to the question of which kind.

Open vs Closed Rhinoplasty

Below we will compare open vs closed rhinoplasty so you can better understand the differences and why may be right for you.

When Closed Rhinoplasty is Preferred

Some procedures, like fixing a deviated septum (septoplasty) or clearing bone protrusions from the nasal passages, are best performed with a closed approach because the additional incision is not needed. Your doctor can complete the surgery safely and effectively with less cutting of tissue.  And fewer incisions mean less chance of infection or swelling and quicker recovery time.

If you’re looking to breathe better through your nose, and reap all the benefits from doing so, you are probably in the market for septoplasty.  If your needs include reducing the size or changing the shape of your nose, you probably need a more extensive rhinoplasty.

While fewer incisions and less extensive recovery are appealing, there are limits to the techniques that can be performed using a closed approach. An open rhinoplasty allows your surgeon more extensive access to the inner structures of the nose.

When Open Rhinoplasty is Preferred

If your nose were a car, an open rhinoplasty is like opening the hood to perform repairs. If you want to do serious work on the engine, you need to be able to see all the components at work.

So, what is considered “serious work?”  Anything that involves a noticeable change in the shape of your nose is a good example. To reduce your cartilage and keep your nose symmetrical, your doctor needs to see your entire nasal structure. Seeing everything allows him or her to make accurate measurements and precise incisions.

And when it comes to extensive rhinoplasty, precision is the key. Patients looking to revise mistakes from prior surgery are also better candidates for open rhinoplasty.  Because there is often an unknown amount of scar tissue and structural changes, an open approach allows your surgeon to make precise adjustments that will give you the results you want.

The Pros and Cons of Open vs. Closed Rhinoplasty

As you seek clarity about the best type of rhinoplasty procedure, it may be helpful to think in terms of pros and cons.

Open Rhinoplasty: Pros and Cons

We’ll start with the open rhinoplasty procedure. Some of the biggest advantages include:

  • The internal structure of the nose is completely revealed, which gives the surgeon much more freedom to reshape the nose to align with your desires.
  • Additionally, open rhinoplasty makes it easier for your surgeon to stabilize the nose post-surgery, compared with a closed rhinoplasty.
  • Open rhinoplasty is more common, which means it could be easier to find a surgeon who is qualified and experienced.

With that said, there are also some drawbacks associated with the closed rhinoplasty:

  • The procedure itself is lengthier and more invasive.
  • Open rhinoplasty comes with a longer recovery period.
  • Open rhinoplasty may also result in greater swelling and bruising.
  • You are more likely to have a lasting, visible scar, though with a skilled surgeon this scar should be very well-concealed.

Closed Rhinoplasty: Pros and Cons

Now, let’s turn our attention to closed rhinoplasty. Some of the most significant advantages include:

  • It’s less invasive and leaves no scars.
  • You won’t have any bruising after surgery.
  • The recovery time will be quite a bit shorter.
  • The procedure requires less time than an open rhinoplasty.

As for drawbacks, consider:

  • Because the surgeon has less visibility, he or she will be more limited in the changes they can make and in the delicacy they can offer.
  • Incisions made in a closed rhinoplasty may weaken the structure of the nose, making it harder to keep it stable in the future.

These are just some of the important considerations to keep in mind as you try to decide between open vs. closed rhinoplasty surgery.

Deciding With Your Doctor’s Help – Open vs Closed Rhinoplasty

You may enter your consultation with a strong preference for having an open versus closed rhinoplasty.   But don’t discount the advice of your physician. He or she has probably performed the procedure many times over and has essential insight into what approach will give you the best possible results.

As you consider your options for open vs. closed rhinoplasty surgery, make sure you consult with trusted local surgeons, like the Charlotte plastic surgeons here at H/K/B. We are one of the most respected options for rhinoplasty Charlotte, NC, and would love to speak with you further about choosing the type of procedure that is best for you. Reach out whenever you’re ready to schedule a consultation.