Open vs Closed Rhinoplasty: Which is Best for Me?

Rhinoplasty, also called nose reshaping surgery, has long been one of the most popular plastic surgeries, with over 352,555 procedures performed in 2020. Not only can it change one’s entire appearance by restoring balance and symmetry to the face, but it can also be used to repair a deviated septum and improve breathing.

But while rhinoplasty is commonly performed, it is exceptionally nuanced, requiring great skill, precision, and planning. The main factor a surgeon must consider when planning a rhinoplasty is whether to use an open or a closed technique. In this post, you’ll learn why this choice is so important, as well as which rhinoplasty technique may be best suited for you.

Open vs. closed rhinoplasty: How are they different?

There are two rhinoplasty techniques used by plastic surgeons: open rhinoplasty and closed rhinoplasty. Here’s how they differ:

Open rhinoplasty

Open rhinoplasty is performed from the outside of the nose; the surgeon gains visibility and access with an added small incision on the underside of the nose between the nostrils. It is the most common type of rhinoplasty performed.

Advantages to open rhinoplasty include:

• It allows your surgeon to better visualize your internal nasal framework
• It provides your surgeon with increased surgical precision
• It preserves your cartilage and your internal nasal structure

Open rhinoplasty allows your surgeon to better visualize, and therefore reshape, your internal nasal framework.

There are, however, a few disadvantages to open rhinoplasty when compared with closed rhinoplasty:

• It leaves a faint scar under the nose, between the nostrils (on the columella)
• It is usually associated with more postoperative swelling
• It may require a longer surgical time

When to have an open rhinoplasty

• You want to make changes to your nasal tip
• You want to correct a crooked bridge
• You are considering a revision rhinoplasty

Closed rhinoplasty

Closed rhinoplasty is performed from the inside of the nose, with incisions made in the nostrils.

There are a few advantages of closed rhinoplasty:

• The skin on the outside of the nose is not affected, therefore it doesn’t leave any visible scars
• There is often less postoperative swelling
• Surgical time is usually shorter

Disadvantages of closed rhinoplasty include:

• It limits a surgeon’s ability to reshape bone and cartilage because they cannot easily see or access the internal structure of the nose

When to have a closed rhinoplasty

• You have thicker nasal skin (thicker skin typically takes longer to heal)
• You want to remove a dorsal hump (a bump on your nasal bridge) but do not need any changes to your nasal tip

Our takeaway: Ultimately, whether you have an open or closed rhinoplasty will depend on your goals and your surgeon’s assessment. At The Swan Center of Atlanta, our plastic surgeons often prefer open rhinoplasty because it allows them to discern which tissues need to be altered and to what extent, which is not easy to do during closed rhinoplasty.

If you are worried about open rhinoplasty leaving a scar, consider that 98% of patients are not bothered by their external rhinoplasty scar, with 90% considering it to be “invisible or barely perceptible,” according to an article in StatPearls. With proper care, your rhinoplasty scar should fade quickly.

98% of patients are not bothered by their external rhinoplasty scar, with 90% considering it to be “invisible or barely perceptible.”

How long does it take to heal from rhinoplasty?

90% of nasal swelling is resolved within 3 months of surgery for most of our Atlanta rhinoplasty patients. And, although it may take up to a year for the last 10% of swelling to fully resolve, it is typically confined to the nasal tip, with small improvements gradually becoming visible.

What other rhinoplasty procedures can I choose from?

Other types of rhinoplasty include:

• Septoplasty is a type of functional rhinoplasty used to correct a deviated septum. Septoplasty only addresses the internal structure of the nose; it doesn’t affect the outer appearance of the nose.
• Tip plasty is a modified form of open rhinoplasty that involves improving only the tip of the nose.

• Flared nostril rhinoplasty. Some patients’ primary concern is the shape of their nostrils; flaring nostrils can be modified with an alar base resection.

• Liquid rhinoplasty uses a series of hyaluronic acid-based filler injections to improve the appearance of the nose. This is a completely non-surgical procedure with almost no downtime. Liquid rhinoplasty is very effective at reducing the appearance of a dorsal hump and increasing projection, but it cannot physically change the shape of the nose or improve its function.

• ‘Ethnic’ rhinoplasty is a term that has been used in the past, however, here at The Swan Center, we simply call nose reshaping “rhinoplasty” regardless of a patient’s genetic background. Our surgeons work with each of their patients to reshape their noses in a manner that suits their unique goals and anatomy.

Which surgeon performs the best rhinoplasty in Atlanta?

There is no single plastic surgeon who could rightfully be called the “best” rhinoplasty surgeon in Atlanta, as our city is home to a number of very experienced and talented cosmetic plastic surgeons. That said, the best rhinoplasty surgeon in Atlanta for you will be a board certified plastic surgeon that shares your aesthetic sensibility, takes time to assess your unique facial anatomy, demonstrates they have the skill to produce your desired outcome with past patient photos, and has a caring and qualified support team to help you all along the way.

How much is rhinoplasty in Atlanta?

Rhinoplasty typically costs between $6,500-$10,000+ in Atlanta depending on:

• Whether or not this cost includes surgeon’s and facility fees
• Whether or not your plastic surgeon is board certified
• Whether or not your surgeon operates in an accredited surgical facility
• The specific nature of your rhinoplasty (cosmetic vs. functional, open vs. closed)

At The Swan Center in Atlanta, rhinoplasty costs approximately $6,900 – $10,000, commensurate with the city’s average.

Learn more about your Atlanta rhinoplasty options at The Swan Center

At The Swan Center, our board certified plastic surgeons have years of experience performing cosmetic and functional rhinoplasties. They will put your mind at ease by helping you determine the rhinoplasty technique best suited for your goals and needs. Visit us online to schedule your Atlanta plastic surgery consultation or give us a call at (770) 667-0904.