What is the difference between Open Rhinoplasty and Closed Rhinoplasty?
Rhinoplasty is performed using either an “open” or “closed” technique. Open rhinoplasty involves the placement of an incision across the small strip of skin that separates the nostrils, also known as the columella. The skin is then pulled back, revealing the underlying bone and cartilage and giving the surgeon greater access to the nasal structure and direct visibility. During the closed approach the incisions are made inside the nostrils, eliminating any visible scars. However, the nasal structures are not visible to the surgeon.
Which is better for me?
When performed by an experienced surgeon, open rhinoplasty involves minimal bleeding and thus results in less swelling afterwards. When performing closed rhinoplasty the surgeon must separate the nasal tissue without being able to see it. This can lead to less accuracy, especially when the surgeon lacks experience, and possibly more bleeding and increased swelling.
Closed rhinoplasty is appropriate in some cases, such as more simple procedures like the removal of a nasal bridge hump. For Asian and other ethnic rhinoplasty cases the open approach may be more suitable for visibility reasons, especially when having extensive work done. Many patients of Asian descent seek rhinoplasty to improve the dorsum, alar base, or lengthen the nasal tip, while still maintaining their ethnic identity. These and other commonly requested alterations can be challenging. However, Asian skin is not conducive to the external approach due to its thickness, leading many plastic surgeons to choose closed rhinoplasty. In doing so they are able to prevent open rhinoplasty scars, but may be hindering the ability to achieve optimal results in other areas. An Asian rhinoplasty specialist like Dr. Nassif will be able to determine which technique is best to help you achieve your aesthetic goals. Dr. Nassif is proficient in both approaches when performing Asian rhinoplasty.
The Importance of Being Open-Minded
Upon entering a rhinoplasty consultation, many patients have already done some of their own research and feel adamant about whether they want an open or closed rhinoplasty. Some favor the idea of a closed rhinoplasty because they are hesitant about visible scars occurring from an incision made on the outside of the nose. Others feel their surgeon would be able to better conduct the surgery being able to see the nasal structure clearly. In the same way, some surgeons have particular views about rhinoplasty technique.
Since every patient is unique, and because of the increased complexity that can accompany Asian rhinoplasty, it is best to carefully communicate to your surgeon your concerns and listen carefully to their recommendations. You should never feel pressured one way or another, but you should also keep in mind that a qualified surgeon who has spent years training and practicing rhinoplasty will have better insight into which approach is appropriate compared to what you have read on the internet. A skilled Asian rhinoplasty specialist will be able to perform either procedure based on the needs of the patient in front of them.
Dr. Nassif is a specialist in rhinoplasty of Caucasian, Asian, and ethnic noses. He is internationally recognized as a leading facial plastic surgeon. Contact his Beverly Hills, CA office at (310) 275-2467 if you are interested scheduling a consultation with the best in the industry.