Nose Job Techniques: Open vs. Closed Rhinoplasty

Differences Between Open & Closed Rhinoplasty 

Board Certified plastic surgeon Dr. Ali has performed hundreds of rhinoplasty surgeries – giving women and men beautiful and natural looking noses that they love.  One concern that many of Dr. Ali’s patients have is the degree of scarring they may experience after a nose job.

As with any surgery, an incision does have to be made during rhinoplasty – in order to access the cartilage that shapes the nose. The type of surgical technique used will determine where and what type of scarring may be possible. However, in the hands of a skilled Board Certified surgeon such as Dr. Ali, the potential for visible lasting scars is reduced while ensuring the most attractive and natural nasal contour.

In this article we explain the different types of rhinoplasty surgical techniques – and how they affect both incisions and the potential for any scarring.

Open vs. Closed Rhinoplasty

“Closed” rhinoplasty is a type of rhinoplasty in which all of the surgical incisions are hidden within the inside of the nostril. While this sounds great, since it avoids a potentially visible scar, it also significantly limits the surgical access area for the surgeon, which limits their ability to utilize many of today’s most effective rhinoplasty techniques.

“Open” rhinoplasty, uses a small (4mm) trans-columellar incision, to connect the right and left nostril incisions- which allows the nasal skin to be folded upward. This gives the surgeon much greater access to the nasal structure, enabling them to modify and/or strengthen the skeletal framework using more advanced techniques.

Although the open rhinoplasty incision initially leaves a small visible scar, it is very tiny (4 mm) and it often fades completely in the months following surgery. In most case, the advantages in contouring gained by the open approach are well worth the limited risk of a tiny scar.

Endonasal Rhinoplasty: A Closed Nose Job

A closed rhinoplasty is also called endonasal rhinoplasty.  Parallel incisions encircle nearly half of the nostril lining, but no part of the incision is seen externally. But, because the right and left nostril incisions are disconnected, the entire operation must be conducted through narrow surgical openings which limits access visibility. Also, because access to the nasal framework requires vigorous stretching of the skin, some distortion of the nasal cartilage is possible. In most cases the considerable challenges and technical limitations of endonasal rhinoplasty makes it an inferior choice – even though it avoids visible scaring.

External Rhinoplasty: An Open Nose Job

An open rhinoplasty is also called an external rhinoplasty.  The small bridging incision, (trans-columellar incision) offers the surgeon direct visibility of almost the entire nasal framework. There is no stretching so distortion of the nasal cartilage is minimize. Most skilled plastic surgeons agree that the small visible columellar scar (which fades over time) is worth the improved accuracy and effectiveness of the open rhinoplasty approach.

For these same reasons, open rhinoplasty is also my preferred approach for primary (non-revision) rhinoplasty since it improves diagnostic accuracy and facilitates precision re-engineering of the misshapen nose. However, the technical demands of open rhinoplasty are rigorous, and substantial dedication and commitment to this approach are required to achieve consistently superior results.

Birmingham’s Best Nose Job Surgeon

In the expert hands of a Board Certified Plastic Surgeon, the open rhinoplasty approach offers a considerable technical advantage over closed rhinoplasty. And because the scar is so small and “beneath” the nose, it is not visible from most angles when looking at the face.

Schedule a Nose Job Consultation with a Birmingham Rhinoplasty Surgeon: 248-335-7200