Open vs. Closed Rhinoplasty What's the Difference?

Open
Closed
Conditions Treated
More Diverse
More Conservative
Incisions
Between the Nostrils
Inside the Nostrils
Scarring
Under the Nose
Virtually None

Comparing Open and Closed Rhinoplasty

If you are unhappy with the size, shape, or projection of your nose, or suffer from breathing issues, you may be considering rhinoplasty

In order to address these concerns, surgeons typically use one of two surgical procedures: open or closed rhinoplasty. Both techniques can help correct cosmetic imperfections, improve breathing, and increase your self-confidence. 

Are the incisions and scarring really the greatest differentiators? 

Open rhinoplasty incisions are made between the nostrils. Closed rhinoplasty incisions are made inside the nostrils. 

How do I decide between the two methods? 

Comparing Candidacy, Incisions, and Treatment Timelines

Complexity of Your Case

In an open rhinoplasty, your surgeon will flip the nasal tip up, providing easier access and a greater range of motion to modify your nose. Meanwhile, a closed rhinoplasty is more popular for minor nasal tip reshaping. Ultimately, your doctor can recommend which method is right for you

Incision Placement

During an open rhinoplasty, your surgeon will make an incision between your nostrils. Although the scar will be visible for a few months, it is hidden on the underside of your nose. If your surgeon makes the incisions on the inside of the nostrils during a closed procedure, scarring is virtually invisible.

Treatment Time and Side Effects

Because a closed rhinoplasty is less invasive, your surgeon can typically complete the procedure in less time. This also means a shorter recovery and a reduced incidence of swelling and bruising.

"The tip may be modified most effectively with the open tip approach (and) dorsum modification is best visualized and precisely modified with an open approach." Jugpal S. Arneja, MD, MBA, FRCSC for Medscape

But both techniques are offered by most surgeons because they offer similar benefits

Both Procedures Are Widely Used to Help Patients Achieve Greater Confidence

Popularity

Whether it be open or closed, rhinoplasty surgery is very popular. According to the American Society of Plastic Surgeons, over 200,000 nose reshaping procedures were performed in 2017 alone.  

Quick Recovery

One of the benefits of rhinoplasty is that it offers a fairly quick recovery compared to other procedures. Most patients only experience swelling and discomfort for seven to 10 days after surgery
 

Discreet Scarring

Both open and closed rhinoplasty offer minimal or virtually invisible scarring

"With proper analysis, realistic patient expectations, and the skills of a qualified facial plastic surgeon, rhinoplasty is a very rewarding procedure for both patient and surgeon alike."
 
American Academy of Facial Plastic and Reconstructive Surgery, Inc.

So which one do surgeons use most? 

Open rhinoplasty infograph

According to a study by JAMA Facial Plastic Surgery, many surgeons perform open septorhinoplasty (OSR) most often because "it has been found useful for most indications except for the 'simple' tip or dorsum." 

Consider the pros and cons of each when talking to your surgeon...

Pros

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Cons

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Are There Other Ways to Address My Concerns?

If you are hesitant about undergoing a rhinoplasty procedure, there are some surgical and non-surgical alternatives. After a consultation with a doctor, many patients discover that an under-pronounced chin is making their nose appear larger. If this is the case, you might consider chin implants instead. 

However, if you have minor cosmetic concerns on the bridge or bulb of your nose, surgery may not be necessary at all. Injectable treatments such as BOTOX® Cosmetic can be used in many cases. Studies have shown that most patients are "very satisfied" with their results after undergoing non-surgical rhinoplasty with injectable treatments or dermal fillers.

Choosing Which Option Is Right for You

Ultimately, your doctor will help you decide whether open or closed rhinoplasty is right for you. If you feel particularly strong about one technique over the other, there are some questions you can ask during your consultation, such as: 

  • Will my scar be noticeable? ​
  • Can my concerns be effectively treated with closed rhinoplasty or do you recommend open rhinoplasty? 
  • What is the recovery time for each? 

Your doctor can give you realistic expectations about what to expect during and after each type of surgical technique so you feel confident and excited about undergoing rhinoplasty. To find out which approach is right for you, schedule a consultation with your doctor today

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