Open vs. Closed Rhinoplasty: A Plastic Surgeon Reveals the Difference

Rhinoplasty (also known as nose reshaping or “a nose job”) is the third most popular cosmetic procedure among Americans. More than 220,000 nose reshaping procedures were performed in the United States last year alone, according to the American Society of Plastic Surgeons.

Rhinoplasty is most commonly performed for one of two reasons: (1) to fix structural defects in the nose that may impair breathing, or (2) to balance the size and shape of the nose with the proportions of the face.

Depending on the reasons you’re getting a rhinoplasty, you may be a candidate for either an open (external) or closed (endonasal) rhinoplasty. Each type of procedure has its benefits and its drawbacks. As a plastic surgery office, we have extensive experience performing both open and closed rhinoplasties and can help you decide which procedure is right for you.

ENDONASAL RHINOPLASTY: THE CLOSED APPROACH

With the closed rhinoplasty approach, all of the surgical incisions are made inside the nostrils, a technique that eliminates visible scarring. And, because the closed approach is less invasive than open rhinoplasty, there is a shorter recovery period.

A scar-free procedure with quicker healing time sounds great, but the closed approach also has some drawbacks. For example, there are usually limitations on the surgeon’s ability to access certain parts of the nose and maneuver surgical instruments, especially while performing more complex procedures. Additionally, this approach typically requires some stretching of the skin around the nose, which may distort nasal cartilage.

It’s for these reasons that endonasal rhinoplasty is ideal for simpler, more straightforward surgeries.

EXTERNAL RHINOPLASTY: THE OPEN APPROACH

The open rhinoplasty approach is similar to the closed approach in that it starts with a few internal incisions. The major difference is that with an open approach, an approximately 5-millimeter, v-shaped incision is made across the columella, the small area on the underside of the nose between the nostrils. This enables the surgeon to fold the nasal skin upward (like lifting the hood of a car) and gain unimpeded access to almost the entire nasal framework, which can help improve the surgeon’s accuracy and overall outcome of the procedure. The open approach also gives the surgeon the ability to create as much symmetry as possible since he or she can see the entire nose at once. The advent of external rhinoplasty has truly revolutionized the treatment of complex nasal deformities.

The most obvious downside to the open approach is that you’ll have a small, slightly visible scar under your nose. In addition, the process of lifting the nasal skin up during open rhinoplasty does tend to lead to more skin swelling compared with using a closed approach. You may also experience temporary numbness on the tip of your nose after open surgery that will gradually resolve within 9 to 12 months.

THE BOTTOM LINE

The type of procedure you ultimately choose depends on many factors: the complexity of the surgery you need, your tolerance for scarring, your general health status, how quickly you’d like to recover, and not least of all, your doctor’s recommendation.

At Northeastern Plastic Surgery, we are highly skilled at both open and closed rhinoplasties. We will happily discuss the pros and cons of each procedure with you and offer our expert opinion on which procedure will yield superior results.

Northeastern Plastic Surgery understands your desire for a beautiful, youthful looking body and facial appearance. We use the latest plastic surgery techniques to perform a variety of surgical procedures. Dr. Fodero and the staff are very friendly, helpful, and available to answer any questions you may have about the procedures we offer. We strive to ensure that your experience with us is positive. Please contact us today to learn more about the services we offer.