Just like a lot of answers on this blog- it depends.
First, let’s define closed versus open rhinoplasty. A closed rhinoplasty is a nose job with a limited incision, typically only in the nostrils. There is no incision in the columella, the vertical strip of skin that’s found between the right and left nostril. An open rhinoplasty, or open nose job, is where a small surgical incision is made between the right and left nostrils.
A closed rhinoplasty is not as common as it was 20 or 30 years ago. Many plastic surgeons have found that being able to see and shape the cartilage while viewing both the right and left side simultaneously really helps to get a better, more symmetric result. A closed rhinoplasty incision doesn’t allow you to see both sides of the nose cartilage at the same time, but only the right side or left side.
For more limited surgery, a closed rhinoplasty is still used today. If the bump on your nose needs to be made smaller, or you need a more limited procedure at the base of your voice, then hidden incisions inside of your nostril are the way to go.
An open rhinoplasty, or open nose job, is when the columella has an incision on it. The columella is the piece of skin that separates the right and left nostril, hidden underneath your nose. The incision across it is usually made to connect the incisions in your right and left nostril. This allows the plastic surgeon to see the cartilage of your nose, on both the right and left side, simultaneously. The cartilage should not be distorted, since the cartilage can be seen on both sides.
An open rhinoplasty approach has become more popular in the past several years, because it allows more surgical exposure and symmetry. There is a higher degree of certainty with your results, because both the right and left sides of your nose are seen at the same time. The small incision on the columella heals well, and is very difficult to see long-term. If you need cartilage reshaping, such as to the tip of your nose or the areas of cartilage above your right and left nostrils, most of the time you will get an open rhinoplasty.
So, which approach is better? It depends completely on what surgical maneuvers you need or want to have accomplished with your nose job.
A closed rhinoplasty should have less swelling and quicker healing. However, most plastic surgeons are only willing to do a closed rhinoplasty for limited procedures.
An open rhinoplasty should be able to give you, the patient, more options with your nose job, along with more confidence that you will get a symmetric result. However, there is the small downside of a tiny incision on your columella. There will probably be more swelling and longer healing with an open rhinoplasty incision.
If you’d like more general information on a nose job in San Francisco, please go to my web page at https://drkim.com/procedures/face/nose-reshaping/.
If you’d like more information on the surgical maneuvers in a nose job, please go to my blog post at https://drkim.com/2010/06/18/what-are-the-major-surgical-maneuvers-in-a-nose-job/.
Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at email@example.com, or call our office at 415-362-1846.
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