Open rhinoplasty and closed rhinoplasty are surgical procedures used to improve the nose on several issues by correcting the nasal asymmetry and enhancing the nasal proportions. Most rhinoplasty is for cosmetic purposes but there can be medical benefits (ability to breath better) to the surgery as well. The primary deciding factors in open vs closed rhinoplasty are what specifically should be changed in the nose, and how big or small these changes are.
Open Rhinoplasty
During an open rhinoplasty procedure, an incision is made along the width of the columella, which is just under the tip of the nose. This will allow the surgeon to lift the skin backwards, as he carefully dissects the nose cartilage. With the skin lifted the surgeon will have ample visibility and increased precision when correcting both cosmetic and functional concerns the patient might have. Once finished, the skin will be re-placed over the bone structure and any external contouring and shaping will be done. Finally, the incision will be closed using sutures and an external splint or cast will be set. The main drawback that is stated by patients for open rhinoplasty is that a small scar remains due to the trans-columellar incision. However, the scar heals significantly by the first 6 months, and it becomes virtually invisible.
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, requiring a highly skilled surgeon with a good understanding of anatomical structure. With closed rhinoplasty, the surgery is generally performed faster than open rhinoplasty as well as the healing and recovery time being shorter. The other significant benefit of closed rhinoplasty is that with this procedure, there is no risk of external scarring due to incisions being made inside the nostril.
