For a cosmetic patient, it can be confusing to understand the difference between open vs closed rhinoplasty. The information available on the internet can, at times, make this even more confusing. In this article we will look to provide some basic information about the difference between the two, and hopefully, help answer some common questions and dispel misunderstanding.
The difference between a closed and open rhinoplasty, put simply, is the different techniques used to access the nasal bone and cartilage to carry out the modification of these structures, and thus alter the shape of the nose. In closed rhinoplasty all the cuts and incisions are hidden inside the nostrils, while in an open rhinoplasty there is a tiny cut on the external skin in-between your nostrils.
The key point to appreciate is that the surgical steps taken by a surgeon after utilising one of these approaches is not linked to the kind of approach – in fact, the surgical steps carried out by a surgeon to modify the nose’s bone and cartilage could be exactly the same as a second surgeon utilising an open rhinoplasty approach. It should be noted that the success and failures of rhinoplasty surgeries are in no way linked to the two techniques mentioned. The decision of what technique to use is down to the surgical experience and technical expertise of your chosen surgeon.
Another common misunderstanding is that closed rhinoplasty isn’t as invasive. If you grasp the key point made above, it will become evident that the invasiveness of the procedure is dependent on the surgical steps taken to modify the nasal bone and cartilage. In fact, many closed rhinoplasty techniques actually necessitate multiple cuts within the internal nasal lining and can be significantly more invasive than the open rhinoplasty approach.
Another type of rhinoplasty procedure is preservation rhinoplasty. While there is no universally accepted definition of this form of rhinoplasty, all reduction rhinoplasty surgeries require removal of excess bone and cartilage. One of the common preservation rhinoplasty techniques is used to remove the hump from the nose. The preservation technique does this by removing excess bone and cartilage from under the natural nasal dorsum, while the classical technique does so by directly removing the excess bone and cartilage from the dorsum of the nose. There is no clear evidence to suggest that the outcome of the surgery is different depending on which technique is used; the outcome will depend on the proficiency with which the surgeon utilises either of these methods rather than the type of surgery.
When deciding on which type of rhinoplasty you should go for you should carefully consider your choice of surgeon. Feedback from previous patients, the experience the surgeon has, research into their past work (such as before and after pictures they have available) are all factors that will come into this As mentioned in this article, the approach (i.e. open vs closed rhinoplasty or the labelled technique i.e. preservation vs classical vs minimal invasive) are just nomenclature which does not predict the success of surgery. These also do not predict the postoperative recovery, swelling or bruising. Consultation with anyone other than your surgeon (e.g. a patient facilitator, marketing personnel, a nurse etc) is a high risk strategy and is not recommended.