Is The Closed Rhinoplasty Technique Going Away? 

All opinions are mine and mine alone.

Is The Closed Rhinoplasty Technique Going Away?  

If you’re thinking about undergoing rhinoplasty, you’re not alone; according to the American Society of Plastic Surgeons, there are more than 220,000 rhinoplasty procedures performed every year in America. A nose job can be used to improve facial symmetry and also correct breathing problems. And for these reasons, it is the most commonly performed facial cosmetic surgery procedure in the country.   

With that said, there are two procedures available to would-be patients, and that is open vs. closed rhinoplasty. 

 Which is right for you?  

Before detailing how to choose between closed rhinoplasty and open rhinoplasty, let’s take a moment to familiarize ourselves with the anatomy of the nose as it may help inform your decision regarding which procedure is right for you. The nose is made up of an upper and lower portion, with the upper portion housing bone and the lower portion housing cartilage. To improve a patient’s breathing or the overall appearance of their nose, a skilled surgeon will have to manipulate the bones or cartilage inside of it, which entails removing or adding more of either material to achieve the desired outcome. Most cosmetic surgeons will perform this manipulation of bone and cartilage using either an open or closed rhinoplasty technique.  

Difference between open and closed techniques  

The primary difference between open and closed rhinoplasty is the type of incision that is required to add or remove bone and cartilage from the nose to alter its appearance. For example, patients who are interested in reducing the size of a small nasal hump on their nose will typically undergo closed rhinoplasty. The same also applies to those struggling with breathing problems, such as a deviated septum, for example. 

 Considered a minimally invasive surgical procedure, closed rhinoplasty entails making small incisions inside of the patient’s nostrils to gain access to bone and cartilage. Because this type of rhinoplasty causes less scarring, it is frequently recommended as a way to correct breathing problems caused by a deviated septum or to make slight adjustments that will help improve the overall appearance of the nose. 

Open rhinoplasty is far more invasive and requires making a columellar incision on the outside of the nose, which provides access to not only bone and cartilage but also the entire nasal cavity and nasal septum. Open rhinoplasty is ideal for removing large nasal humps or for patients interested in major nasal reconstruction that requires large cartilage grafts. While both open and closed rhinoplasty procedures have a high success rate, typically 85 to 90 percent, open rhinoplasty can cause visible scarring that will remain visible for 3 to 6 months following surgery.  

Dr. Mark Glasgold, expert nose surgeon of New Jersey, mentions that most of the rhinoplasty surgeries performed in his practice are of the open variety. He states there are advantages to the open technique like having better visualization and control of the nasal structure during surgery, also any resulting post-op scars being hardly noticeable. 

 Is closed rhinoplasty going away? 

 Contrary to popular belief, closed rhinoplasty procedures are not going away. In fact, they continue to be offered by a wide range of highly skilled cosmetic surgeons. The reason why open rhinoplasty is performed more frequently than closed rhinoplasty is that it is a slightly less complicated procedure and also one that many surgeons feel more comfortable performing.   

According to an article published by Harvard Health Publishing, closed rhinoplasty is not only harder to learn but also harder for many surgeons to perform. For these reasons, very few surgeons offer this approach to rhinoplasty even if its the better choice based on the wants and needs of the patient.  

Choosing the right cosmetic surgeon  

As with any matter involving your health, you will want to exercise due diligence when choosing a cosmetic surgeon for your rhinoplasty procedure. That said, here are a few tips to help you get started: 

Choosing a board-certified cosmetic surgeon can provide you with some additional peace of mind when you undergo either an open or closed rhinoplasty procedure. In short, these practitioners have received additional training and education that is specific to their specialty, which could be rhinoplasty, facelifts, or any other form of cosmetic surgery. Some of the more well-regarded organizations that award board certifications include the following:  

• The American Board of Medical Specialties 
• The American Board of Physician Specialties 
• The American Osteopathic Association 

It is worth noting that none of these organizations are any better than the other; if your prospective surgeon has been board-certified by any one of these organizations, you can rest easy knowing that they have taken the extra steps needed to provide their patients with the best possible care.  

Ask about your surgeon’s experience 

Along with choosing a board-certified surgeon, it is also a good idea to choose one who has a lot of experience in performing rhinoplasty procedures. After all, even if they are proficient in breast augmentation procedures, for example, it does not mean they will have the same level of expertise when it comes to rhinoplasty. To that point, consider asking your prospective surgeon the following questions: 

• How many rhinoplasty procedures have you performed? 
• Do you perform both open and closed rhinoplasty procedures? 
• Do you have before and after photos from past patients? 
• Will the surgery be performed in a facility approved by the state medical board? 

It is important to note that this list does not encapsulate all of the questions that you should be asking your prospective surgeon; moreover, they are a few of the ones that can provide you with enough information to make your decision-making process that much easier.