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Open vs Closed Rhinoplasty: Differences and Choices

Open vs Closed Rhinoplasty Differences and Choices

Deciding to alter your nose can vary based on your desired outcome. The main difference between open and closed rhinoplasty lies in the approach to accessing the nasal structures. In open rhinoplasty, a small incision is made across the columella, allowing for better visibility and access to the nasal framework. Conversely, in closed rhinoplasty, all incisions are made inside the nostrils, resulting in no external scarring but limited visibility for the surgeon.

To understand whether open or closed rhinoplasty is right for you, it’s important to know the differences and benefits of each approach. Here, we share insights from Dr. Luis Macias, a renowned double-certified plastic surgeon specializing in rhinoplasty.

Open Rhinoplasty

Open rhinoplasty involves making an incision on the columella, the strip of skin between your nostrils. This allows the surgeon to lift the skin and soft tissue, providing a direct view of the nasal structure. This technique is often used for complex cases requiring significant changes to the nasal structure.

Dr. Macias typically makes two incisions inside the nose and one across the columella (trans-columellar incision) to lift the skin and access the nasal framework. He then reshapes the nasal structure, straightens the septum if necessary, and closes the incisions. Dr. Macias recommends open rhinoplasty for:

  • Significant refinement of the nasal tip
  • Dramatic changes in the nose’s size or shape
  • Thick-skinned noses

The procedure, performed under general anesthesia at Aesthetic MdR, usually lasts two to three hours.

Closed Rhinoplasty

Closed rhinoplasty is a minimally invasive technique involving two small incisions inside the nostrils, with no external incision. This approach is less invasive, has a shorter recovery time, and leaves no visible scars. Dr. Macias uses specialized instruments to reshape the nasal structure through these internal incisions.

This procedure, also performed under general anesthesia, typically takes one to two hours. Since the incisions are inside the nose, there is less swelling and bruising post-surgery, leading to a quicker recovery.

Which Should You Choose?

Your Desired Goals

Closed rhinoplasty is suitable for temporary, reversible changes, such as improving the nasal profile, enhancing tip projection, and minimizing bridge irregularities. It’s ideal for patients without functional issues and those seeking a non-surgical approach.

Open rhinoplasty is more versatile, addressing various aesthetic and functional concerns, such as structural problems, size modifications, and nostril shape changes. It’s the choice for fixing nasal bumps, improving facial harmony, alleviating breathing problems, and correcting snoring.


Closed rhinoplasty leaves no visible scars as all incisions are inside the nostrils. Open rhinoplasty involves a small incision on the columella, which is typically inconspicuous once healed.

Surgical Time

Closed rhinoplasty usually takes 30 minutes to two hours, depending on complexity, and is easier for the surgeon to perform. Open rhinoplasty requires more time (one to four hours) and precision due to its intricate nature.

Recovery Time

Recovery for both procedures is similar, generally up to a year for complete healing. Minor discomfort, swelling, and bruising are common immediately after surgery. While bruising subsides within weeks, swelling may take up to a year to dissipate fully. Temporary changes in the sense of smell and breathing difficulties usually resolve within weeks.

Determining the Right Procedure

At Aesthetic MdR, Dr. Macias uses cutting-edge 3D Vectra imaging to help patients visualize the potential results of both procedures. This technology creates a three-dimensional image of your face and allows you to see how different rhinoplasty techniques could affect your appearance.

Consult with Dr. Macias

To determine which rhinoplasty procedure is right for you, schedule a consultation with Dr. Luis Macias at Aesthetic MdR. His expertise in both open and closed rhinoplasty ensures you receive personalized recommendations based on your unique needs.

For a comprehensive understanding of the differences between open and closed rhinoplasty, be sure to read the full article on our blog: The Open or Closed Rhinoplasty: What’s the Difference?


Published by: Khy Talara

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