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What is the difference between an open and closed rhinoplasty?

Rhinoplasty, often referred to as a “nose job,” is a cosmetic procedure aimed at reshaping or reconstructing the nose to enhance aesthetic appearance or function.

Tagged: Facial Treatments

Author: Mr. Bryan Mayou, MB ChB FRCS

Date: 22nd February 2021

Medically Reviewed by:  Mr. Bryan Mayou (GMC: 1414396)

Last reviewed: 26th February 2024

What is an Open Rhinoplasty?

An open nose rhinoplasty, also known as an open nose job, is an invasive operation used to reshape or reconstruct the nose by creating an incision in the columella - the strip of skin between the nostrils underneath the nose.  

Open nose surgery is performed to improve the aesthetic appearance or function of the nose. Following the incisions, the skin is lifted to allow access to the nasal cavity and enable the surgeon to perform reshaping.  

This technique provides the surgeon with direct access to the underlying nasal structures, including cartilage and bone, allowing for meticulous adjustments and corrections. After the surgery is complete, the columella is sutured, and the nose is secured in place with tape and a splint. The splint keeps the nose in place during the healing process and is normally removed after one week.  

Open rhinoplasty is an excellent option for patients with issues such as genetic or structural deformities, following trauma to the nose requiring grafting, or unsatisfactory results from a previous nose job. 

What is a Closed Rhinoplasty?

Closed rhinoplasty, also known as a closed nose job, is the most common type of nose surgery. This surgical procedure is used to reshape or reconstruct the nose without making any external incisions to the surface of the nose.  

Instead, all incisions are made inside the nostrils, thus leaving no visible scars. Because this technique does not provide a direct view of the nasal skeleton, it is usually undertaken by surgeons with more experience.  

Closed nose surgery is generally reserved for the less complicated nose operations or small revision modifications.  

What is the Difference Between an Open and Closed Rhinoplasty?

The main differences between the Open Rhinoplasty procedure technique and the Closed Rhinoplasty procedure technique lies in the incision placement and visibility of nasal structures during the procedure: 

Open rhinoplasty involves a small incision made on the columella, allowing for better visibility and precision in making adjustments.  

Closed rhinoplasty involves incisions made entirely within the nostrils, with no external cuts on the nose’s surface. This approach leaves no visible scarring.

Open Rhinoplasty provides the surgeon with a clear view of the nasal anatomy, facilitating more extensive and complex corrections. This in effect enables better manipulation of nasal cartilage and bone.  

Closed Rhinoplasty limits visibility and access to the nasal structures, as the surgery is performed through narrow nostril openings. This may make it more challenging to perform complex modifications.  

Open Rhinoplasty is well-suited for complex or extensive nasal reconstructions, which offers greater versatility in addressing various aesthetic and functional concerns. 

Closed Rhinoplasty is typically performed for less extensive or more moderate nasal corrections, as it may have limitations in addressing certain structural issues due to limited access.  

Open Rhinoplasty may result in a small scar on the columella, which typically heals well and becomes discreet over time. Recovery times may be slightly longer due to the more extensive nature of the surgery.  

Closed Rhinoplasty leaves no visible external scarring since all incisions are made inside the nostrils. Recovery times are often quicker compared to an open rhinoplasty due to the procedure being less invasive.  

When is an Open vs Closed Rhinoplasty More Suitable?

When it comes to considering the suitability of open vs closed rhinoplasty, the decision is dependent upon various factors: 

Open Rhinoplasty: 

  • Suitable for complex or extensive nasal reconstructions. 
  • Ideal for cases requiring precise adjustments.  
  • May be the preferred option when addressing significant nasal asymmetry or deformities.  

Closed Rhinoplasty: 

  • Ideal for cases with minimal structural issues or those requiring less invasive procedures. 
  • Effective for patients seeking subtle changes for nasal appearance. 
  • May be preferred for patients concerned about visible scarring.  

Are Closed Rhinoplasties More Complex than Open Rhinoplasties?

Closed rhinoplasties provide less visibility and access to the surgeon than open rhinoplasties. This may make it more challenging for surgeons to perform extensive or complex nasal reconstructions.

Do You Recover Faster From a Closed Rhinoplasty?

Patients typically recover faster from a closed rhinoplasty compared with an open rhinoplasty. Since closed rhinoplasty involves incisions made entirely within the nostrils, there are no external scars, and the surgery is less invasive.  

As a result, patients may experience less swelling, bruising, and discomfort following the procedure. Of course, recovery times can vary from person to person and recovery can be greatly assisted if a patient follows the aftercare instructions. 

We ask that patients take at least two weeks off work to rest and recuperate and not to drive during this time. Sleeping on the back is recommended for four weeks post-surgery. UV light should be avoided for between two and four weeks to lessen the likelihood of scarring. 

In terms of physical activity, restricted sexual activity can be resumed after four weeks, but the gym and strenuous exercise should be avoided for six weeks. If a patient follows these instructions, we would expect them to recover by six to eight weeks. 

We ask that patients come in and see our nursing team one week after surgery to ensure incision sites have been properly reviewed. At this juncture we also recommend meeting with one of our on-site aestheticians to discuss ongoing treatment to support the healing and scarring process. 

A final check-up will take place six weeks after surgery. 

Is a Closed Rhinoplasty Cheaper?

Despite the differences in technique, both types of surgical rhinoplasty procedure start from £6,900 at the Cadogan Clinic. 

Given inevitable variations in facial anatomy between patients, procedural costs are highly dependent upon the complexity of the procedure required, and the technique employed, however.  

A closed rhinoplasty could be cheaper than open rhinoplasty, however the price is not always significantly different. The final price will be confirmed following a patient’s face-to-face consultation with one of our expert surgeons. 

Which is Better, an Open vs Closed Rhinoplasty?

Neither approach is inherently “better” than the other; rather, each technique has its own benefits and considerations. For patient results, please see our closed rhinoplasty before and after page. 

Open rhinoplasty is typically recommended for patients who want to change the size of their nose, have their nose tip corrected, have a prominent dorsal hump removed, or reverse the results with a revision rhinoplasty 

Closed rhinoplasty is less intrusive and is commonly used to address issues such as obstructed airways, reducing a bridge bump or minor tip problems. This technique also minimises scarring. 

Frequently Asked Questions

Any surgical operation carries the risk of scars developing. Although an open rhinoplasty scar is likely to occur, it is usually well concealed and relatively discreet.  

The incision for open rhinoplasty is made on the columella, which is the strip of skin between the nostrils. While the open rhinoplasty scar may initially be visible, it generally heals well over time and becomes less noticeable as it fades and blends in with the surrounding skin.  

With proper care and healing, many patients find that the scar from open rhinoplasty is barely noticeable.  

The duration of an open rhinoplasty compared with a closed rhinoplasty can inevitably vary as it is dependent on several factors, including the complexity of the procedure and the surgeon’s experience.

Every patient is different, and although our surgeons are highly skilled and experienced in both types of procedures, individual cases may have subtle differences that influence the time for completion.

In general, open rhinoplasty may take slightly longer than closed rhinoplasty due to the additional steps involved in creating and closing the external incision on the columella. On average, an open rhinoplasty may take about 2-3 hours, while a closed rhinoplasty may take about 1.5 - 2  hours. However, it is important to note that these time estimates can vary, and it is essential to discuss the specifics of your procedure with our surgeons during the consultation process.  

Words From Our Founder

Mr. Bryan Mayou

Open and Closed Rhinoplasty are both beneficial when treating nasal concerns. While Open Rhinoplasty allows for correction of the internal structures within the nose addressing functional concerns such as breathing difficulties, Closed Rhinoplasty involves internal incisions, allowing for limited external scarring. The choice between the two is based on the concerns and the desired results of the patient. During my career, I have reguarly seen how both of these procedures benefit patients and help to address their concerns effectively.
Mr. Bryan Mayou

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