Frequently Asked Question: What is the Difference between Open vs Closed Rhinoplasty?

Patients often ask about the difference between open vs closed rhinoplasty. More importantly, they want to know which might be the best for their needs.

We hope this article helps as you process the nearly overwhelming number of cosmetic surgery options. The article isn’t a substitute for highly-personalized medical care, but it is a starting point as you research your options.

Let’s Start With More Details on Rhinoplasty

Rhinoplasty, otherwise known as a nose job, is a surgical cosmetic procedure done to reshape the nose.

People opt for rhinoplasty for a variety of aesthetic and medical reasons. A nose job can reduce a bump on the nose, straighten a crooked nose, sculpt the tip of the nose or alter the nose’s size. Rhinoplasty is also done to help improve the patient’s ability to breathe. 

People often request nose jobs because they believe:

  • Their nose is either too big or too small for their face.
  • They feel their nose is too wide or too narrow for their face.
  • Their nose is asymmetrical or crooked, possibly because of a prior accident or injury,
  • They don’t like the way the tip of their nose or their nostrils look.
  • There is a bump or hump on the bridge of the nose that bothers them.
  • They may also have therapeutic issues, such as correcting a deviated septum.

As plastic surgeons, we are here for our patients, whatever the reason, and we strive to help them work through these highly personal choices.

The American Society of Plastic Surgeons outlines who might be a good candidate for a nose job. Of course, any prospective patient should seek individual advice and an examination from a board-certified plastic surgeon. Here are a few of the signs:

  • You are in good physical health.
  • Your facial growth is complete.
  • You do not smoke.
  • You have realistic expectations of what can be accomplished and are optimistic about surgery.

The Key Differences Between Open vs Closed Rhinoplasty

About Open Rhinoplasty

Open Rhinoplasty is performed from outside the nose through a tiny incision on the fleshy space between the nostrils. This method offers the surgeon easier access to the entire nose.

The surgeon creates a small incision along the width of the columella (the space between nostrils). If the surgeon needs to fix the nose structure after a collapse or perform more in-depth reshaping, they will probably need to perform an open rhinoplasty.

If you previously had a nose job and received revision rhinoplasty, you will most likely need open rhinoplasty.

Open rhinoplasty is more versatile, so it works well when your surgeon needs to add cartilage, graft bone, or other tissue or use other advanced reconstruction techniques.

In summary:

  • Ideal for significant reshaping or fixing the structure of the nose.
  • A small scar is visible from the undersurface of the nose.
  • The nose typically swells more because it is a more invasive procedure than closed rhinoplasty. Rhinoplasty recovery is also a little slower for the same reason.
  • Your physician has an easier time stitching, and the stitches are both inside and outside. The inner stitches are absorbed; the outer stitches will need to be removed a week or so after surgery.
  • Since the nose’s internal structure is completely revealed, your surgeon has more visibility, better access, and more freedom to manipulate and reshape the nose.
  • This option provides more potential for transformation and structure.

About Closed Rhinoplasty

During closed rhinoplasty, your surgeon accesses the areas from within the nostril area. This method works best for minor reshaping and corrections.

The cartilage framework is “delivered” through small incisions, and your surgeon manipulates as required.

Since it is a less invasive type of nose job, recovery and healing are typically faster. Another plus is this method results in no visible scars.

The downside is you are limited by what your surgeon can do through the tiny incisions making it an option only for minor reshaping.

Closed rhinoplasty is a highly advanced surgical technique, so be sure to ask your prospective surgeon about their experience with this technique.

In summary:

  • Ideal for minor fixes like reshaping the tip of the nose.
  • There are no visible scars.
  • Since it is a less invasive procedure than open rhinoplasty, recovery time is shorter and less swelling afterward.
  • Any stitches are inside the nose and are absorbed over time.
  • This method has limitations, so it isn’t as versatile as open rhinoplasty.

Most insurance doesn’t cover elective cosmetic surgery. Insurance may cover rhinoplasty when there is a functional or therapeutic need. In either case, your plastic surgeon’s practice might work with you on financing and payment options.

Which Type of Nose Job is Best For You?

The choice between open vs closed rhinoplasty usually depends on the type of work being done. While under the care of a skilled surgeon, you can see excellent results with either method as long as it is appropriate for your operation.

Basically, more complicated work requires an open approach, especially if it involves adding cartilage and significant manipulation. For more significant reshaping and reconstruction, open rhinoplasty may be your only or best option. On the other hand, if you are receiving minor reshaping of the tip of the nose, then closed may be perfect for your needs.

To learn your specific options, have a frank discussion with your plastic surgeon and rhinoplasty specialist. They will recommend based on experience, expertise, and your needs.

Next Steps; Contact a Board Certified Plastic Surgeon

The team at Charlotte Plastic Surgery feels honored that Charlotte-area residents trust their noses to us. While the eyes may be considered the gateway to the soul, the nose is the central feature of the face. Sometimes small changes help someone move from feeling self-conscious to confident.

We love seeing satisfied patients face the world with confidence that they look and feel great! Contact us today to schedule a consultation and learn what modern rhinoplasty can do for you.