By: Richard Rival, MD

Cosmetic nose surgery typically takes one of two forms: “open” (internal approach) rhinoplasty, or “closed” (external-approach) rhinoplasty. While some surgeons strongly favor one approach over the other, like most rhinoplasty surgeons in Toronto I base the choice of approach on each patient’s specific physical characteristics.

Last week, I outlined the advantages of open (external-approach) rhinoplasty (see last week’s post); this week I will be shifting focus to look at how closed (internal-approach) rhinoplasty works, and how it compares to the open approach.

Closed (Internal-Approach) Rhinoplasty:

How It Works: While open rhinoplasty requires the surgeon to pull the soft tissues away from the nasal bone and cartilage, closed rhinoplasty does not. Instead, this type of nose surgery in Toronto allows the surgeon to adjust the shape and appearance of the nose from the inside out, through incisions made within each nostril. Although closed rhinoplasty does not offer the same kind of visibility and direct access to nasal structures as the open approach does, it can still achieve very accurate results.

Advantages: Closed rhinoplasty generally requires less dramatic manipulation of the nasal tissues; it may therefore allow for shorter operating and recovery times. The incision sites are not visible from the outside, so although open-approach rhinoplasty scars are typically invisible, many nose surgery patients in Toronto still feel more comfortable with the closed approach.

Why This Approach Might Make Sense for You:

• You mainly want to correct a hump on the bridge of the nose and your nose is straight
• You only wish mild or moderate change to the shape or position of the tip of your nose

In most cases, I find that revision surgeries tend to require the open approach, simply because I need to understand as clearly as possible how the previous surgeon adjusted the tissues, but in some cases the closed approach will be equally as effective, depending on the kinds of improvements the patient expects to see. In the end the approach used is not nearly as important as the result you end up with. Your choice of surgeon should not be dependent on the approach he or she uses but the overall quality of the results he or she can achieve for you.

Further Resources:

• Read “Open vs. Closed Rhinoplasty: How to Decide, Part 1″ (Open Rhinoplasty)
• See open-approach rhinoplasty in 3D
• See real rhinoplasty patients’ results

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