Overview

Rhinoplasty, commonly referred to as nasal surgery, can be performed using two main surgical approaches: open rhinoplasty and closed rhinoplasty.

Both methods aim to address structural or functional concerns of the nose, and each has its own indications depending on the individual’s anatomy and the complexity of the surgery.

Understanding the differences between these approaches helps patients have informed discussions with their surgeon about which method may be most appropriate for their situation.

What Is Open Rhinoplasty?

Open rhinoplasty involves a small external incision placed across the columella — the narrow tissue between the nostrils — called a trans-columellar incision.

This incision connects the internal incisions within the nostrils, allowing the nasal skin to be gently lifted for greater visibility of the underlying cartilage and bone structures.

This open approach provides the surgeon with direct visual access to the nasal framework, which can be useful in more complex cases such as:

• Correction of significant structural deformities.
• Revision surgery following previous rhinoplasty.
• Reconstruction after trauma or congenital conditions.

The incision typically measures a few millimetres, and any resulting scar is usually discreet and may fade over time.

What Is Closed Rhinoplasty?

In closed rhinoplasty, all incisions are made inside the nostrils, meaning there are no external scars.

Through these internal incisions, the surgeon can access and reshape the nasal cartilage and bone.

This approach may be suitable for patients requiring limited adjustments, as it allows for internal modification while maintaining the integrity of the nasal skin.

Because the nasal skin remains intact, the procedure can sometimes involve shorter operative and healing times.

However, the closed approach may not be appropriate in all situations — particularly when significant structural reconstruction or grafting is needed.

Your surgeon will advise whether an open or closed method is more suitable based on your anatomy, surgical goals and clinical findings.

Comparing the Two Techniques

Both open and closed rhinoplasty are established surgical techniques. The key differences include:

• Incision location:
  • Open: a small external incision on the columella.
  • Closed: all incisions inside the nostrils.
• Visibility:
  • Open: provides direct view of nasal structures.
  • Closed: limited visibility but avoids an external incision.
• Complexity and indication:
  • Open: often used for major structural changes or revisions.
  • Closed: generally used for less complex, limited refinements.

Your surgeon will determine which method best aligns with your clinical and anatomical needs.

Recovery and Postoperative Care

Recovery from both open and closed rhinoplasty varies between individuals.

In general:

• Swelling and bruising may occur and gradually subside over several weeks.
• Numbness or tightness at the nasal tip is common but usually temporary.
• Avoid strenuous activity and protect the nose from impact during the early healing period.
• Attend all scheduled follow-up appointments to monitor healing progress.

The healing process continues for many months, and subtle changes in nasal definition may occur as swelling resolves.

Surgical Consultation and Assessment

Before any nasal surgery, patients undergo comprehensive assessment and counselling, which includes:

• Review of medical history and nasal function.
• Physical examination and discussion of treatment options.
• Explanation of surgical techniques, risks, and potential outcomes.
• Mandatory cooling-off period before scheduling the procedure.

These steps help ensure that each patient makes an informed decision based on clear medical information rather than aesthetic expectations.

Consultation with Dr Shahidi

Dr Shahram Shahidi

BSC(MED)(HON I) MB BS(SYD) FRACS FAAFPS

MED0001167352

Specialist Otolaryngologist (Ear, Nose and Throat) – Head and Neck Surgeon

Member, Australasian Academy of Facial Plastic Surgery

Dr Shahidi is an Australian-trained and FRACS-qualified ENT surgeon with more than 20 years of experience in nasal and sinus surgery.

He assesses each patient’s nasal structure, function and medical history to recommend appropriate management options and explain the surgical approaches available.

Disclaimer:

All surgical and invasive procedures carry risks. Individual outcomes vary.

Before proceeding, patients are encouraged to seek a second opinion from an appropriately qualified health practitioner.