People may seek rhinoplasty for a variety of reasons: a nose may appear too large, too wide, or asymmetrical, for example. For this reason, every procedure is tailored specifically to meet an individual’s cosmetic needs. At our Los Angeles facial plastic surgery clinic, we offer multiple techniques to accommodate the personal goals and preferences of each patient.
When it comes to nose surgery, one particular difference in technique is open v. closed rhinoplasty. While neither option is inherently better, some surgeons or patients may prefer one over the other, due to their inherent advantages and disadvantages. Before undergoing treatment, take a moment to learn how each of these techniques is employed.
Although some surgeons may be equally comfortable and proficient in either technique, closed rhinoplasty tends to be a more traditional and conservative procedure. First, incisions will be made from inside the nostrils, resulting in no external scars. Through these incisions, pieces of cartilage and bone are removed or positioned to redefine the overall shape of the nose. Once finished, the incisions are closed, ultimately leaving little if any hint of surgery.
Like the closed technique, open rhinoplasty utilizes intranasal incisions to readjust bone and tissue within the nose. The chief difference, however, is that open surgery also utilizes a single incision in the columella - the skin and cartilage that divides the nostrils. By temporarily separating and lifting the skin of the septum, surgeons have additional access to the nose’s tip and bridge. Although this does require an external incision, this skin tends to heal incredibly well, often leaving little or no permanent scarring.
The Advantages and Disadvantages of Each Technique
Both closed and open rhinoplasty have the potential to create similar results, but the advantages of each are largely dependent on the patient’s needs and the surgeon’s experience. For example, if a patient has a deviated septum and needs it to be repositioned, a septoplasty will always require an external incision in order to move the skin and cartilage of the septum. Additional considerations for each technique include:
- Closed rhinoplasty: The primary advantage to a closed rhinoplasty is the lack of visible scarring. While some patients may opt for this, especially those with a history of problematic scarring, it may also be recommended due to a surgeon’s personal experience with the technique. However, closed rhinoplasty requires additional skill and precision by a surgeon to adjust tissues within the nose.
- Open rhinoplasty: By providing access near the tip of the nose, an open rhinoplasty allows surgeons greater ease in the modification of bone and tissue. Consequently, the open technique can more easily produce superior results. While some patients may not like the idea of having an additional incision that can potentially leave a scar, the surgical benefits still tend to outweigh the risk of more difficult technique.
Which Technique Is Right for You?
Surgeons who are comfortable with the open rhinoplasty technique will generally find it more desirable, and may recommend it for a majority of patients. However, some patients may not benefit as much from the open technique. A closed rhinoplasty may be equally efficient if the nose is not very long, does not over- or under-protrude from the face, is not crooked, and if the tip requires little or no work. Essentially, the less work required, the better a surgeon can work without an incision at the columella.
Still, the best way to determine the right surgical technique for you is to speak with your doctor. After assessing the shape of your nose and predicting your results, a procedure can be recommended that is medically and aesthetically preferable.
Schedule a Consultation with Us
Meet with Dr. Keyes for an in-depth consultation to determine your candidacy for rhinoplasty. Contact us to schedule an appointment or to inquire about our alternative plastic surgery treatments.