Open vs. Closed Rhinoplasty FAQs

What is the primary difference between an open rhinoplasty and a closed rhinoplasty?

To perform an open rhinoplasty, the plastic surgeon will make an incision across the columella (the column of skin that separates the two nostrils) to gain access to the underlying cartilage and tissue. A closed rhinoplasty does not involve any incisions on the outside of the nose, and is typically performed when the amount of revision required is minor. Dr. Sam Rizk is highly skilled at both approaches and will determine which approach will work best for his patient during the initial consultation. When appropriate, Dr. Rizk may use a hybrid approach that he has pioneered, which combines the open and closed techniques. When using this approach, Dr. Rizk changes the structure of the bridge internally, and then modifies the tip via a partial opening.

For what conditions will a closed rhinoplasty be used?

Dr. Rizk will select a closed rhinoplasty for patients who are seeking only to change the bridge of their nose, and require little or no tip revision. Additionally, if the patient has a symmetrical tip and a long nose, Dr. Rizk can lift the tip via closed rhinoplasty. To repair external nasal valve collapse or a pinched tip, closed rhinoplasty can be performed, provided the tip of the nose has a good support structure.

For what conditions will an open rhinoplasty be used?

Patients with thick skin, weak tip cartilage, and or an asymmetrical tip generally require an open rhinoplasty. If a patient is undergoing revision or secondary rhinoplasty, there is generally poor tip support, thus an open rhinoplasty is often the preferred approach. Additionally, an open rhinoplasty is required when dorsal implants or nasal tip grafts are being used. Open rhinoplastys are performed more often than closed rhinoplastys, as this approach gives the surgeon added visibility and allows for a higher degree of revision.

Do some surgeons offer only one type of rhinoplasty?

Some surgeons are more skilled at performing one of the two methods; however, you should make your decision based upon the success stories of previous patients, not on the method with which the doctor excels. Many plastic surgeons feel strongly that one approach is better than the other. The important part is that the doctor is able to identify and perform the approach that is appropriate for each individual patient. Dr. Sam Rizk is skilled at open, closed, and hybrid open/closed rhinoplasty. He believes that plastic surgeons should always evaluate the patient to determine the best surgical approach to meet the patient’s goals. There are advantages to both approaches, and each should be used when the situation demands.

Does open rhinoplasty result in scarring?

To perform an open rhinoplasty, a small incision must be made in the columella; however, a skilled surgeon like Dr. Rizk will be able to suture the nose so skillfully that the scar will barely be visible. Most people are not able to see the fine line that remains after the nose has completely healed. The fear of scarring should not deter you from undergoing an open rhinoplasty, as the scar itself is not significant.