×

Blog

The Difference Between an Open & Closed Rhinoplasty

Rhinoplasty surgery (nasal surgery) is one of the oldest plastic surgical procedures in the world – there’s actually archaeological evidence suggesting that early forms of rhinoplasty were performed thousands of years ago in ancient India and Egypt. Today, rhinoplasty remains one of the most popular plastic surgeries in the world for both females and males thanks to its myriad of aesthetic and reconstructive uses and the fact that the procedures have been refined to create artistic natural appearing results.

What Can a Rhinoplasty Achieve?

Before deciding which type of rhinoplasty (open or closed) is right for you, it’s important to understand what rhinoplasty surgery can accomplish. Rhinoplasty has a wide range of both cosmetic and medical benefits.

  1. Rhinoplasty can be used to repair damage to the nose.

The earliest rhinoplasties ever performed were conducted for the purpose of rebuilding the patient’s nose after injury. The practice of using surgery to restore the nose to its prior shape and functionality has evolved to be able to produce a more natural appearing result.

When the nose is broken during an accident, it can heal improperly unless surgical corrections are performed in order to help the nasal bone and cartilage “set” properly. Improper healing can cause a range of secondary issues, including a nose that appears bent or flat and restricted breathing. Many fully trained experienced plastic surgeons are able to perform a functional rhinoplasty concurrently with a cosmetic improvement. In fact, since cosmetic and functional problems often go hand-in-hand, the best rhinoplasty surgeons are able to fix functional issues during a cosmetic rhinoplasty and create a natural-looking nose during a functional rhinoplasty.

  1. Having a “nose job” can correct life-long breathing problems.

Many people have congenital abnormalities that can greatly obstruct their breathing. Problems like a deviated septum (a condition wherein the nose cartilage develops at a slant, partially blocking one nostril), nasal polyps, or an unusually flat, low nasal bridge can all make it more difficult for a person to breathe through his or her nose.

Thankfully, functional rhinoplasty, which includes special procedures like septoplasty and turbinate surgery, can help with breathing problems beyond nasal congestion and snoring. Functional rhinoplasty allows the surgeon to correct a deviated septum (as the lower portion of the nose must be surgically repositioned to open up the nasal passages), remove polyps found deep in the nostrils, or work with severely damaged bone and cartilage.

While difficulty breathing through the nose sounds like a mere annoyance, it can actually lead to a wide range of potentially serious problems. Obstructed nasal passages can result in frequent sinus infections, which can become serious enough to harm the patient’s quality of life. Poor airflow through the nose can also cause sleep apnea. While sleep apnea can be treated with the use of a special breathing machine, many patients find these machines uncomfortable to use. Moreover, although these machines can ease symptoms, they may not be a long-term solution.

Functional rhinoplasty, however, has been shown to help with a bevy of breathing problems, including nasal obstructions and sleep apnea. This is important because untreated or partially treated sleep apnea has been linked to a range of medical issues, including high blood pressure, obesity, and type two diabetes. In short, it’s important to treat obstructed airways before they lead to more serious problems.

  1. Rhinoplasty surgery may improve your career prospects.

Rhinoplasty surgery has long been a favorite procedure of those in the entertainment industry and public arenas, and for good reason: since the nose is a visual focal point on the face, it’s a crucial part of a person’s overall appearance. Those who make a living with their face, either in acting or modeling, need to look as good as possible – especially if their face is being magnified on the big screen. Using rhinoplasty surgery to make sure the nose is completely in proportion with the rest of the face has helped thousands in the entertainment industry look more photogenic.

In a world where our every action can be documented by our cell phones, the nose figures prominently in the satisfactory overall balance of the facial photograph. We have become much more conscious of our social media appearance.

  1. Rhinoplasty can increase your confidence.

This is, of course, the number one reason why most people seek cosmetic surgery: They want to feel better about how they look (and there’s absolutely nothing wrong with that, as long as one is realistic about their motivations and what can and cannot be achieved.) Having rhinoplasty surgery can ensure that your best features have a chance to shine, as observers will no longer be distracted by an overly prominent or oddly-shaped nose. The nose should be in harmony with the other facial features.

Who Is a Good Candidate For a Rhinoplasty?

A reasonable candidate is an individual who is interested in changing the shape of the nose to improve facial balance as long as her or his goal is realistic, is in good medical condition, and understands and accepts the tradeoffs and possible problems that may occur with the surgery.

What to Expect After Having a Rhinoplasty    

When a surgeon performs rhinoplasty surgery, he or she must work with the bone, cartilage, and supportive tissues that already exist within the patient’s nose. As such, no plastic surgeon can give you an entirely “new” nose. Your surgeon also can’t just look at a picture of a nose and recreate it entirely. What you will be able to achieve, however, is a nose that is much more balanced with your facial features.

Open vs. Closed Rhinoplasty: What You Need to Know

When you elect to have rhinoplasty surgery, your surgeon will advise you at the consultation whether you would benefit from an “open” rhinoplasty or a “closed” technique. In a closed rhinoplasty all of the tiny incisions are made within the nose. With the open procedure an additional incision is made across the columella (the vertical structure between your nostrils at the base of the nose. The difference between an open rhinoplasty and a closed approach is the external incision and scar scar across the columella with an open approach which is unnecessary with a closed approach. The incisions are performed to access the structural tissues that are responsible for creating the nose’s shape. Similar alterations, with either approach, will then be made to these underlying nasal tissues in order to improve its appearance.

Excellent cosmetic results can be achieved with both techniques. There is not a best way to perform the procedure. Individual surgeons have their own preferences of how to produce the best results in their hands. What is more important than whether a closed or open approach is utilized are the experience, skill and artistry of the plastic surgeon and your comfort level and confidence in that individual.

There are no hard-and-fast rules for which technique is better; it really all depends on your anatomy and the experience of the surgeon. Choosing a technique should be done on a case-by-case basis, but what really matters is the skill of the surgeon performing your procedure. Your surgeon should be able to explain what technique will work for you and why.

As a final note, it’s important to develop realistic expectations regarding what rhinoplasty surgery can and can’t do before you book your consultation.  There are limits to what a rhinoplasty can accomplish. Open and closed rhinoplasty are different techniques, but they have the same outcomes: improving the structure and function of the nose and creating a more harmonious nose that should blend in with your other facial features.

Recovering From Rhinoplasty Surgery

It’s essential that patients understand how important it is to follow the proper healing protocol after having any type of rhinoplasty surgery.

Most patients are urged to take at least 1 week off from work, school, and social activities for recovery. Bruising and swelling around the eyes are to be expected and are quite variable. It usually starts to subside after 48-72 hours following the surgery. In most patients the bruising will have disappeared or can easily be concealed at 10-14 days, when the splint comes off. The tip of the nose may feel numb for 4-12 months. Most patients look socially acceptable at 10-14 days, but swelling continues to diminish over months. Patients may temporarily feel self-conscious about their appearance, but it is generally not noticeable to others after a couple of weeks. It may take up to one year for the nose to achieve its ultimate appearance.

When Can You Exercise After Having a Rhinoplasty?

Patients are urged to avoid strenuous exercise that raises their pulse rate, including: jogging, aerobics, swimming, working-out, brisk walking, and sex for a minimum of 3 weeks after surgery. You need to be involved in your care and follow all of your plastic surgeon’s instructions in order to help diminish post-operative problems like bleeding. Once exercise is resumed, it is common for patients to experience temporary throbbing of the nose and swelling which may last for a few hours.

It is recommended to avoid contact sports for 4-6 weeks.

Can Computer Imaging Be Used to Predict the Appearance of the Nose?

Computer imaging is an excellent communication tool to show the direction one wants to go in improving the appearance of the nose. However, you have to be realistic and understand that it is only a computer drawing and you may not get that exact result, because it does not show the unpredictable aspects of healing, nor unexpected physical aspects of the nasal interior.

Individualization

Every nose is different and unique to that individual. If the appearance of your nose concerns you enough to do something about it, it can be improved with a natural artistically performed rhinoplasty. What would be the best option and exact procedure would depend on an in person examination (not just an online consultation) and discussion about desired outcome. Excellent results can be achieved with either a closed or open technique.

Keep in mind that following advice from a surgeon on any website who proposes to tell you exactly what to do and how technically to do it based on two dimensional photos without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of the operative procedure would not be in your best interest. Natural appearing results need to be individualized and what is appropriate for one patient is not necessarily the best for someone else.

Celebrity nose

Rather than trying to look like someone else, it is important understand what can and cannot be accomplished with your nose in order to be in harmony with your other facial features. The shape of a nose that looks good on a particular celebrity may look inappropriate on someone else and not be in balance with their other features. The goal should always be to try look as good as you can, not look like someone else.

Consultation

Want to fix your breathing problems while also achieving your cosmetic goals? You should work closely with an experienced and board-certified plastic surgeon in order to determine what kind of results rhinoplasty can generate for you. To learn what rhinoplasty can do for you, contact the office of internationally renowned rhinoplasty surgeon Dr. Robert Singer for a consultation.

Ready to Get Started?

Fill out the contact form below to schedule your consultation with Dr. Singer