Open vs. Closed Rhinoplasty: How to Decide (Post 1 of 2)

Most of my nose surgery patients in Toronto are aware that there are two basic approaches to cosmetic nose surgery: “closed” (internal approach) rhinoplasty, and “open” (external approach) rhinoplasty. However, while most rhinoplasty surgeons will outline the differences between these two approaches, some patients undergo one or the other procedure without understanding why that approach makes sense for their specific case.

In today”s post I want to outline what open-approach rhinoplasty is, and give a few examples of situations where this approach might be the most effective for you. Next week”s post will do the same for closed-approach rhinoplasty.

Open (External-Approach) Rhinoplasty: The Basics

How It Works: In an open rhinoplasty, the surgeon makes a small incision across the columella, the soft tissue between the nostrils. The surgeon gently separates the surface-level soft tissues from the harder inner structure of the nose and pulls the soft tissues upward. The surgeon can then reshape the bone and cartilage of the nose before he or she re-positions and soft tissues and makes any necessary adjustments to the nose tip.

Advantages: This approach is popular with many rhinoplasty surgeons in Toronto because it allows for much greater visibility and control of the tissues during nose surgery. While both the open and closed approaches are equally precise in the hands of an experienced surgeon, for more extensive revisions many rhinoplasty surgeons in Toronto prefer the open approach simply because they can see everything much more easily. Studies suggest that this approach offers better results than closed rhinoplasty for reconstructive procedures, especially.

Why This Approach Might Make Sense for You:

  • You want to make extensive structural corrections to your nose, such as reducing a large nasal hump, correcting a severely deviated septum, or reconstructing your nose after a previous rhinoplasty
  • Your surgeon plans to adjust the position or width of the nasal tip, for example lifting a “drooping” nose tip or significantly augmenting or reducing the nasal tip”s size

Note that while many surgeons offering nose surgery in Toronto will lean heavily either for or against this approach, in my experience the patient”s nasal structure is the best key to planning an effective result. Learn more about how this approach compares to closed rhinoplasty in next week”s post on Open vs. Closed Rhinoplasty.

Further Resources:

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