Should I have open or closed rhinoplasty? What is the difference?
Open rhinoplasty begins with an incision across the columella, the central pillar of the nose, and continues by lifting the nasal skin off the cartilage and bone. Its advocates say that “working with every structure in view gives good results”. Yet although many surgeons now perform open rhinoplasty, why is the revision rate still so high?
Closed rhinoplasty also involves incisions, but they are placed inside the nostrils and are therefore invisible. It is difficult for a surgeon without enough experience in this technique, because the work is done in a narrow space. But of course it is not blind surgery, performed without seeing anything and leaving the result to fate. Almost every structure we touch can be seen as comfortably as in open rhinoplasty, including the nasal tip. Every manoeuvre in open rhinoplasty can also be done in closed rhinoplasty, without opening the nose. Swelling (especially at the nasal tip) settles faster after closed rhinoplasty. And in open rhinoplasty, not even the surgeon can see the final result clearly until the columella stitches are placed and the nose is closed.
Overall, many of our colleagues achieve excellent results with open rhinoplasty. I can also understand why the closed technique looks very difficult from the outside to a surgeon who has not mastered it. But I do not accept a surgeon who has not mastered the technique telling you that closed rhinoplasty is not possible for you. As you can tell from what I have written above, you could say I am a devotee of closed rhinoplasty.
The information on this page is for general information only; always consult your doctor for diagnosis and treatment.