There are two approaches when performing a rhinoplasty; an open and closed approach. Dr. William Sabbagh at the Straith Clinic in the Metro Detroit area explains the difference between the two and his preferred methods: open vs closed rhinoplasty.
The open approach involves an incision externally on the columella, which is the tissue between the nostrils that connects with the internal incisions. To Dr. Sabbagh, this is by far the most common approach to rhinoplasty. The main reason is because it’s far more precise. The cartilages at the tip are completely exposed, and in many cases, this is where irregularities or asymmetry occurs. It also allows for better exposure to the dorsal hump is to be removed or decreased. The open rhinoplasty is also the appropriate method when performing surgery of the septum to improve breathing, such as a septoplasty or the insertion of spreader grafts.
Closed rhinoplasty is primarily used for noses that need less dramatic improvement. Examples may include those that are completely symmetrical and straight, but have a small bump or need a slight amount of tip thinning.
Open vs Closed Rhinoplasty Methods
There is no truth that the open rhinoplasty takes noticeably longer to heal or for the swelling to go away. There is also no significant increase in swelling with this procedure in comparison to the closed approach. A trained, experienced, and board-certified plastic surgeon will recommend the technique that he or she is most comfortable with, and providing the best opportunity to correct any irregularities the patient is uncomfortable with.