Open Rhinoplasty vs. Closed Rhinoplasty: Guide
One of the most confusing dilemmas in rhinoplasty is deciding on what technique to use to obtain the best results. It is always good for patients to become well-informed about procedure options so that they can make the right decision about their health and appearance. There are two different approaches to reshaping the nasal tip: open rhinoplasty and closed rhinoplasty.
Key facts:
. Open rhinoplasty involves an external incision in the columella, whereas there is no external incision in closed rhinoplasty.
. Open rhinoplasty leaves a scar on the columella (the bridge between the nostrils), but no visible scars are left after closed rhinoplasty.
. In open rhinoplasty, the nasal skin is lifted during the operation and the surgeon has good control over and access to the nasal structure, whereas the skin is not lifted in closed rhinoplasty, hence the limited visibility and maneuverability.
. Open rhinoplasty is the preferred method for patients who need extensive modification to their nose.
. Closed rhinoplasty is suitable for those who need small changes to their nose and want to heal faster.
. Most surgeons are better at performing rhinoplasty with the open approach, while some may be better at closed rhinoplasty.
. Closed rhinoplasty takes a shorter time than the open approach.
. Recovery and healing are faster in closed rhinoplasty than open rhinoplasty.
Comparison between open and closed rhinoplasty
| Open rhinoplasty | Closed rhinoplasty | |
| Suitable for | Extensive changes | Small changes |
| Procedure time | Longer | Shorter |
| Visualization (visibility of nasal structure during operation) | Excellent | Limited |
| Delicacy (difficulty of surgery) | Less | More |
| Recovery time | Longer | Shorter |
| Swelling and bruising | More | Less |
| Visible scar | Only seen when you tilt back your head | No |
Introduction
People decide to undergo rhinoplasty for different reasons. Some want to correct their deviated septum, which is making their breathing difficult, some just don’t like the small hump of the nasal bridge, and others might want a fundamental transformation.
If you have weighed up everything and made up your mind to go under the knife and get a nose job for whatever reason, chances are you’ve heard the terms ‘open rhinoplasty’ and ‘closed rhinoplasty’ while you were gathering information about the nose job procedure.
Open rhinoplasty and closed rhinoplasty (also known as endonasal rhinoplasty or ‘scarless’ rhinoplasty) are the two main approaches to rhinoplasty. Open and closed rhinoplasty refers to two distinct techniques of operating on a nose.
The Differences between Open and Closed Rhinoplasty
What is an Open Rhinoplasty?
An open rhinoplasty is used to treat the nasal tip and middle portion of the nose. It involves the use of a small bridging incision to link incisions to the right and left nostrils. The bridging incision allows the nasal skin to be folded upward, thereby providing full access to the lower nasal skeleton.
What is a Closed Rhinoplasty?
During a closed rhinoplasty procedure, the incisions are hidden inside a patient’s nose. A closed rhinoplasty involves modifications performed inside the nostrils. As such, a closed rhinoplasty is generally recommended for rhinoplasty patients who require nasal bridge modifications.
Closed rhinoplasty was the first method of nose surgery, which is still being widely used by many surgeons. In this procedure, small incisions are made inside the nostrils and the surgeon makes alterations to the nose through the nostrils without lifting back the skin. With the advancement of surgical techniques, however, open rhinoplasty is more widely used nowadays.
The main difference is that while open rhinoplasty is a type of nose surgery for fixing the functional or aesthetic problems of the nose performed by making an incision on the soft tissue between the nostrils (columella) and lifting back the nasal skin, closed rhinoplasty is performed for the same purpose but with all the incisions made inside the nostrils without the nasal skin being lifted back.
That said, closed and open rhinoplasty methods are different in several other ways and have their own pros and cons. Continue reading to find out the advantages and disadvantages of open and closed rhinoplasty methods and whether you should go for the former or the latter.
Advantages and Disadvantages of closed and open rhinoplasty
What are the advantages of open rhinoplasty?
. Open rhinoplasty has some advantages over the closed approach, which are as follows.
. Since the nasal structure is completely revealed, the surgeon has better access to the underlying structure and thus more freedom to reshape the nose as the patient desires.
. The stabilization of the nose after surgery is easier in open rhinoplasty than closed rhinoplasty.
. Most surgeons practice open rhinoplasty. Therefore, your chance to find a good surgeon for open rhinoplasty is greater.
What are the Disadvantages of open rhinoplasty?
The main drawbacks of open rhinoplasty are as follows:
. Open rhinoplasty is lengthier and more invasive than closed rhinoplasty, so the recovery time will be a little longer and it takes more time for the swelling and bruising to disappear.
. A very small scar might remain on your nasal columella, though only visible when you tilt your head back.
What are the Advantages of closed rhinoplasty?
. Closed rhinoplasty is less invasive and leaves no scars and less swelling and bruising after surgery, so there will be a shorter recovery time and downtime.
. Closed rhinoplasty procedure takes a shorter time to be completed that open rhinoplasty does.
What are the Disadvantages of closed rhinoplasty?
. As there is limited visibility of the tissues and cartilage, the surgeon can make limited changes, with less delicacy.
. There are fewer surgeons who are skillful at closed rhinoplasty than open rhinoplasty.
. Incisions made in the nose weaken the nasal structure, undermining the stability of the shape of the nose in the future.
. There is a higher chance of nasal cartilage distortion during the operation as accessing the nasal framework requires intense stretching of the skin.
Recovery time
Since closed nose surgery is less invasive than the open method, there will be less swelling and bruising after this surgery and the nose will heal faster. There might even be no bruising after closed rhinoplasty in some patients. Therefore, the recovery time in closed rhinoplasty is shorter than in open rhinoplasty and patients usually need a shorter time to be able to return to their normal life.
Cost
Since closed rhinoplasty requires more skill and there are fewer surgeons who perform this procedure, it usually costs more than a typical open nose surgery. While the duration of an open nose procedure is longer than the closed method, the latter is a more complex and difficult procedure and is often frowned upon by surgeons. That is why some nose surgeons charge patients more for closed rhinoplasty. That said, some surgeons may charge a lower fee for closed rhinoplasty.
Conclusion
Depending upon the patient’s natural anatomy and desired results, closed rhinoplasty can be a good option. In many cases, however, the improved accuracy and access of the open technique is a far greater benefit than the minor risk of visible scarring. In fact most rhinoplasty surgeons regard open rhinoplasty as the procedure of choice for difficult nasal anatomy of any type, and many of the most effective techniques of contemporary rhinoplasty can only be performed through the open approach.