Open vs. Closed Rhinoplasty

Patients may undergo rhinoplasty surgery for a variety of reasons. The surgery can correct a breathing problem resulting from injury or birth defect, or it can improve the aesthetics of the nose by reducing the size, removing a hump from the bridge, or narrowing the nose. These improvements are made by either an “open” or “closed” technique.

An open rhinoplasty, also called “external rhinoplasty,” involves a transcolumellar incision (between the nostrils), where the skin and nasal tissue are pulled back so that

the surgeon can have more direct access to the nasal structure. A closed rhinoplasty, or “endonasal rhinoplasty,” involves several very small incisions within the nostrils.

Since an open rhinoplasty is more invasive than a closed rhinoplasty, many patients are concerned with visible scarring and a longer recovery time. The fact is, there are many factors to consider with both techniques, and they both have certain advantages and disadvantages.

Open Rhinoplasty

Any small maneuver the surgeon makes can affect the form or function of another area of the nose. Therefore, when significant improvement must be made to the nose, it may be better for the surgeon to have more “room” to see and to operate. Although the procedure and recovery times are longer with the open technique, there is less risk of nasal cartilage distortion and more opportunity for the surgeon to easily make adjustments.

The open technique is most often recommended in the following cases when significant improvement must be made:

  • If grafts or implants must be used
  • If this is a revision rhinoplasty
  • If there has been significant trauma to the nose or face
  • If the patient has a cleft lip
  • If the nose is twisted

If noticeable scarring is the main concern, a skilled plastic surgeon like Dr. Shah will be able to very precisely re-align the columella so that the scar is barely detectable on any skin type.

Closed Rhinoplasty

Since the outer contour of the nose is directly affected by the underlying structure, significant changes can be made endoscopically with the closed technique. This technique involves less swelling and recovery time, and no scars will be visible because incisions are made inside the nostrils. However, without an external incision, the nasal skin must be significantly stretched in order for the surgeon to reach the nasal framework, which can distort the nasal cartilage. Limited access to the nasal structure can also affect the quality of the results.

Top rhinoplasty surgeon Dr. Shah has ample experience providing fantastic results with both the open and closed technique. Depending on your nasal structure, your health, and your desired results, Dr. Shah will recommend the procedure that is best for you. Be sure to view Dr. Shah’s rhinoplasty before and after photos for an idea of the results you can expect with rhinoplasty.

If you are interested in rhinoplasty in the Columbus area, please fill out our contact form or call (614) 482-2123 to schedule a consultation.