Open or Closed Rhinoplasty? Which one to choose? The purpose of Rhinoplasty (Nose Job) is…
If you are considering rhinoplasty, you will no doubt have come across two different terms used to describe the procedure – ‘closed’ and ‘open.’ These terms describe slightly different approaches to surgical access to the nose during the procedure, which we explain in our guide below.
Both approaches share a number of the same incisions but the major difference is that closed rhinoplasty involves only internal, or endonasal, incisions. This means that no incisions are made on the outside of the nose, rather they are just inside the rim of each nostril. Open rhinoplasty involves an incision being made at the base of the columella, which is the narrow wall of soft tissue that separates the nostrils. This enables the surgeon to lift off the skin from the nose so that a better view of the cartilage and bones can be attained before shaping is carried out. Closed rhinoplasty is therefore a more complex procedure, demanding significant skill from the surgeon, but its benefits over open rhinoplasty are clear and demonstrable.
The enormous advantage closed rhinoplasty has over the open approach is that it is far less invasive, so there are no visible scars and patients can enjoy a quicker recovery time. Clearly, the avoidance of surgical dissection whilst still having the ability to make targeted improvements is of enormous benefit. Because the nose is not being dissected, closed rhinoplasty usually results in shorter procedure times and can reduce the amount of postoperative swelling and bruising. There is also no risk of external scarring as no incisions are made outside of the internal structure of the nose.
Rhinoplasty requires vast surgical skill but successful procedures also involve a degree of artistry as your surgeon is essentially re-sculpting your nose. Ensuring your nose gives you the appearance you have always wanted, whilst looking natural and functioning perfectly, is truly a work of art. As the nose is not taken apart during closed rhinoplasty, it is far easier for the surgeon to judge how the nose will look post-surgery, something that is generally not as clear in open rhinoplasty procedures.
Although in many cases closed rhinoplasty offers a multitude of benefits over open rhinoplasty, there are times when an open approach can be beneficial. For example, if structural grafts are required to bring the nostrils down, or in cleft lip operations. The important thing is to keep an open mind when attending the consultation with your surgeon, as they will know which approach is best suited for your situation. If it is deemed necessary to carry out open rhinoplasty, be assured that, in the hands of a skilled, experienced surgeon, the external incision is usually undetectable once it has healed.