Open Vs. Closed Rhinoplasty- The Big Difference

Making the decision to cosmetically enhance your nose by having a rhinoplasty procedure can be overwhelming. Advancements in technology have allowed many different options when deciding which type of rhinoplasty procedure is best for you to obtain your desired look and fulfill your aesthetic needs.

Whether you are looking to reshape your natural nose, alleviate structural issues that impede breathing or repair damage, rhinoplasty remains one of the most popular cosmetic surgery procedures done each year. Patients often find themselves perplexed when deciding between having an open rhinoplasty procedure or a closed rhinoplasty procedure. Open vs. closed rhinoplasty refers to the two possible surgical approaches to reshaping your nasal tip. Although many incisions are used in both approaches, the main difference between the two is one small incision called the Trans-Columellar Incision performed in the open approach rhinoplasty. There are pro’s and con’s associated with each approach, and Dr. Miller is dedicated to helping you choose which one best suits your aesthetic needs. Here we break down the two approaches providing you with the knowledge to make an informed and well thought out decision.

The closed approach, also called Endonasal Rhinoplasty is executed by positioning all surgical incisions inside the nostrils therefore leaving no traces of the incision, avoiding any visible scars. This approach offers decreased operative time as well as less swelling during post operative healing. The downside to this approach is that due to the technique of this procedure, the left and right nostril incisions remain disconnected. By creating incisions that disconnect the right and left nostril, your surgeon has limited visibility when repositioning the nasal skin. Endonasal Rhinoplasty must be conducted through narrow surgical openings, limiting access to the nasal framework forcing your surgeon to strenuously stretch your nasal skin inevitably disfiguring the nasal cartilage.

The open approach, also called External Rhinoplasty, differs from the closed approach because it connects the left and right nostril incisions allowing the nasal skin to be lifted off of the tip of the nose like lifting the hood of a car, ultimately making it easier for the surgeon to see and work on your nasal tip cartilage. This is done by making a small incision, which we mentioned earlier, in the columella which is the soft tissue separating your left and right nostril. This approach allows direct visibility to your entire nasal framework minimizing the chance of disfiguring the nasal cartilage and allowing your surgeon to better visualize the reshaping of your nose.

The closed approach offers a great incentive by eliminating the risk of having visible scars, but the open approach offers more versatility, effectiveness and accuracy with only a modest risk of seeing any scars. It is important to choose the right access method when removing the nasal skin to facilitate exposure to your nasal skeletal framework. Changes to your nasal contour are a result from the corresponding changes to your nasal skeleton allowing you to achieve optimal results from your rhinoplasty procedure.  The open approach offers considerable technical advantage over the closed approach when looking at the bigger picture of what is best for you and your surgeon during your rhinoplasty procedure.

For more information in regards to specific rhinoplasty techniques and the procedure which may be best suited for you, please contact our office to schedule a consultation with  top board-certified facial plastic surgeon, Dr. Philip Miller. Dr. Philip Miller and team are happy to assist you with an assessment as well as provide you answers to any concerns, questions, and other information regarding rhinoplasty treatments available.


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