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Closed or Open Rhinoplasty? What is the difference?
By: Dr. Leppink

I believe that most Plastic Surgeons prefer the Open technique Rhinoplasty approach for most of their patients.

When I was in my residency a Closed technique Rhinoplasty approach was used most commonly. This meant that the surgery was performed through incisions on the inside of the nose using instruments placed blindly into the tissue planes of the nose. In expert hands the results could be very good, but many times the results were inconsistent because of the “blind” approach.

An Open technique Rhinoplasty requires the use of an incision across the skin between the nostrils that then extends into the nose. Through this incision the skin of the nose is lifted exposing the cartilage and bone beneath the skin. This allows the Plastic Surgeon to know exactly what the anatomic issues are and be very exact in fixing them. Measurements can be made and structure and support can be tested to be sure that the framework left behind is exactly what is needed to achieve the results desired. The tradeoff for this control is a small hardly visible scar on the skin between the nostrils.

Most Plastic Surgeons believe that the tradeoff of a small scar for better control is worthwhile!

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