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What’s The Difference Between Open & Closed Rhinoplasty?

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A rhinoplasty, otherwise known as a nose job, can be performed two ways: open or closed. Open rhinoplasty is performed outside the nose and involves an incision placed on the columella (which separates the two nostrils). A closed rhinoplasty involves incisions only made within the nostrils.

What Is Rhinoplasty?

Rhinoplasty is a cosmetic procedure to improve the appearance of the nose and create or restore a more optimal and pleasing facial symmetry. Rhinoplasty may also be performed to improve the functionality of the nose. Patients may decide to have a nose job to open airway flow, repair obvious and unsightly imperfections, and improve the overall aesthetic appearance of the nose itself. Since the nose is very delicate and sensitive, rhinoplasty is an intricate and complex facial cosmetic surgery.

Open (External) Rhinoplasty

Open rhinoplasty is performed by making a small incision on the columella, which is the soft tissue that separates the nostrils. Open rhinoplasty is also known as external rhinoplasty. The procedure is performed while the patient is under general anesthesia or twilight sedation. After the incision is made, the surgeon can easily access the nose’s underlying bone and cartilage structure.

Advantages Of An Open Rhinoplasty

Open rhinoplasty allows the surgeon to lift the skin of the nose off the tip, allowing them unparalleled access to the underlying bone and nasal tip cartilage. When the nasal skin is lifted above the tip cartilage structure, a more significant reshaping and structural graft support capacity can be accomplished. In addition, open rhinoplasty allows for easier suturing or grafting and provides a clearer view of all corrections that need to be made during the procedure. In short, an open rhinoplasty can facilitate a more drastic change to the shape and structure of your nose than closed rhinoplasty.

In addition, open rhinoplasty allows your surgeon to be much more precise which, since the nose is such a delicate and sensitive part of the face, can provide better overall results.

Disadvantages Of An Open Rhinoplasty

There are two potential disadvantages of open rhinoplasty. The first is that, because an incision is made on the columella, there is the potential for the patient to end up with a visible scar. However, as an experienced cosmetic surgeon with a focus in rhinoplasty, Dr. Bell will take every precaution necessary to ensure any visible scarring is minimal. Overall, most open rhinoplasty procedures do not result in significant visible scarring of the columella.

The second potential disadvantage is that, compared to a closed rhinoplasty, open rhinoplasty results in more substantial swelling following the procedure. This swelling is temporary and only lasts for a short length of time following the procedure.

Closed (Internal) Rhinoplasty

Closed rhinoplasty, also known as internal rhinoplasty, involves incisions inside the nose, through the nostrils. This method is less intrusive and is most often used to correct obstructed airways, minor nose tip problems, or to reduce a bridge bump.

Advantages Of A Closed Rhinoplasty

If a rhinoplasty can be done closed (i.e. if the procedure does not involve significant aesthetic corrections), there is no risk of external scarring, as all of the incisions are done on the inside of the nose. In addition, there is less swelling during the recovery period, and the procedure generally takes less time.

Disadvantages Of A Closed Rhinoplasty

Because closed rhinoplasty is less invasive, it is only ideal for patients who wish for a minimal amount of work. More substantial, detail-oriented procedures cannot be done with closed rhinoplasty; therefore, minimal cosmetic changes are possible.

black and white photo of woman looking into mirror

Which Is Better: Open Or Closed Rhinoplasty?

While there are differences and specific advantages and disadvantages to each kind of rhinoplasty, no one type of procedure is better than the other. Dr. Bell will consult with you to determine the desired outcome of your rhinoplasty, which will help determine whether an open or closed rhinoplasty is ideal for you.

It is also often the case that a combination of both open and closed rhinoplasty will produce the best possible cosmetic outcome.


Is One Option More Affordable Than The Other?

Because an open rhinoplasty is a more complex and invasive procedure that requires more advanced surgical techniques, it is generally the more costly of the two types of rhinoplasty. At SpaMedica, the cost of a rhinoplasty procedure starts at $8,999.

Are The Results Different For An Open VS Closed Rhinoplasty?

While the techniques differ between an open and closed rhinoplasty, both types of procedures can be used to achieve your desired results, depending on what those results may be. Instead of focusing on the procedure, Dr. Bell will work with you to determine your desired outcome and then advise on which type of rhinoplasty will achieve these results.

Does Skin Color Affect Whether An Open Or Closed Rhinoplasty Should Be Performed?

No, skin colour has no bearing on whether an open or closed rhinoplasty is best. This is often a concern among patients who are worried that any scarring will be more visible on certain skin tones, but in all cases, scarring will be minimal and virtually invisible.

Dr. Thomas Bell | SpaMedica

by Dr. Thomas Bell

Dr. Tom Bell, with over 25 years of practice experience dedicated to cosmetic plastic surgery, pioneered Avenue Road and Yorkville as Toronto’s Beverly Hills of plastic surgery with his first surgical center in Yorkville’s Avenue road corridor back in 1986. Named as Canada’s best plastic surgeon by W magazine and one of the world’s best, Dr. Bell returns home to join the SpaMedica Plastic Surgery team as the reigning King of Plastic Surgery.
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