Rhinoplasty

What is the Difference Between Open and Closed Rhinoplasty?

Posted on by Dr. Alev Camcıoğlu

Patients considering rhinoplasty need to make an important decision between open and closed rhinoplasty. Both methods aim to improve the shape and function of the nose but involve distinct technical differences. While open rhinoplasty provides the surgeon with a broad field of view, facilitating complex structural changes, closed rhinoplasty is a less invasive approach that leaves no visible scar. However, the advantages and limitations of each method vary depending on the patient’s needs, nasal anatomy, and the surgeon’s experience.

How Do Incision Locations Differ in Open and Closed Rhinoplasty?

The main difference between open and closed rhinoplasty lies in the placement of the incisions and the degree of access they provide to the surgeon. In open rhinoplasty, an external incision (transcolumellar incision) is made on the columella, the area that separates the nostrils. This incision allows the cartilage and bone structures beneath the nasal skin to be fully exposed. This method is especially advantageous in cases of complex nasal deformities or revision procedures, granting the surgeon a broader view and more precise intervention. During the procedure, this direct access facilitates detailed reshaping. However, the transcolumellar incision can leave a small external scar. Typically, this scar is not very noticeable and tends to become less visible over time.

In closed rhinoplasty, by contrast, all incisions are made inside the nostrils. Since there is no external incision on the nose, it leaves no visible scar. A less invasive approach is employed to protect the nasal skin and tissues. Because the internal incisions offer limited access, however, it can be more challenging for the surgeon to work extensively on the nasal structures. The closed method is generally considered appropriate for simpler forms of nasal reshaping.

What Are the Pros and Cons of Open Rhinoplasty?

Open rhinoplasty offers a broad field of view during the surgical procedure, which is a major advantage for complex nasal reshaping operations. Allowing the surgeon to examine nasal structures in detail, this method is particularly chosen in sensitive cases that require detailed corrections, such as severe deformities or revision surgeries. Lifting the nasal skin makes it possible to accurately assess and correct asymmetries and structural issues. However, there are also some disadvantages to the open technique. Although the risk of scarring from the small incision on the columella is low, it cannot be completely eliminated. In addition, because it is a more invasive method, the recovery period may last longer compared to closed rhinoplasty. The extended operation time can pose an additional challenge for certain patients. A balanced assessment of the advantages and disadvantages of open rhinoplasty is essential for planning an approach that meets the patient’s needs.

What Are the Pros and Cons of Closed Rhinoplasty?

Closed rhinoplasty stands out in rhinoplasty surgery as a technique that leaves no scars and accelerates the healing process. Among its advantages is the fact that all incisions are made inside the nostrils, resulting in no external scarring. This is an important aesthetic benefit, especially for patients who do not want a visible mark on their face. Additionally, closed rhinoplasty typically involves a shorter surgical procedure compared to the open method. This shortens the anesthesia duration, enabling patients to begin the postoperative recovery process sooner. Thanks to its minimally invasive nature, swelling and bruising after surgery are usually milder, speeding up one’s return to daily activities.

Nevertheless, this method also has its disadvantages. Because the surgeon’s field of view is limited in closed rhinoplasty, it can be challenging to correct complex nasal structures or cases that require extensive reshaping. This technique demands high technical skill and experience, as it involves working in a confined space and reshaping the nasal structures. In instances where severe nasal deformities must be corrected, the closed approach may not offer sufficient access. If desired results are not achieved in such cases, revision surgeries may be necessary. Owing to the limited field of view, there is a risk of inadvertently damaging nasal structures, which can result in complications.

How Does the Recovery Period Compare in Open and Closed Rhinoplasty?

The recovery period after rhinoplasty varies depending on the type of procedure and the scope of intervention. Because open rhinoplasty fully exposes the nasal structures, the healing process is typically longer. Noticeable swelling and bruising can be evident within the first few weeks after surgery, and edema in the nasal tip area in particular may continue for several months. It can take a year or more for the final shape to become fully apparent. During this time, it is important to allow the nose to heal naturally and attend regular follow-up appointments with the surgeon.

Closed rhinoplasty, meanwhile, is a less invasive approach and therefore usually involves a faster recovery period. Since the incisions are inside the nose, there are no external stitches or scars, and postoperative swelling and bruising are less pronounced. Patients can often return to their daily routines within a few weeks and achieve the final shape of their nose in a shorter timeframe compared to open rhinoplasty.

In both methods, the initial healing phase lasts about 1–2 weeks. During this period, external splints and internal packing materials are used to support the nasal structure. However, because swelling may persist longer after open rhinoplasty, patients need to exercise more patience to see the final result of their nose.

Which Rhinoplasty Technique Is Right for You?

Determining the most suitable technique for patients considering rhinoplasty depends on both aesthetic and functional goals, as well as individual anatomical features. Open rhinoplasty provides the surgeon with the advantage of directly seeing the nasal structures and correcting complex deformities. This method is generally ideal for cases requiring large-scale shape changes or detailed reconstruction. Patients with thick skin or significant structural abnormalities may achieve better results through open rhinoplasty.

Closed rhinoplasty, on the other hand, is a less invasive method performed using incisions solely inside the nostrils. The absence of a visible scar and a shorter recovery period make it a preferred option for simpler nasal corrections or situations that require minimal changes. Although this technique restricts the surgeon’s access, it can offer effective and satisfactory results in appropriate patient groups.

The choice between these two methods depends on factors such as the patient’s expectations, nasal anatomy, skin characteristics, and any breathing problems. Moreover, the surgeon’s experience and chosen technique can be pivotal for achieving a successful outcome. It is essential for patients to undergo a thorough evaluation with an experienced plastic surgeon to understand their unique needs and objectives.