11th Jul 2025
Open Rhinoplasty or Closed Rhinoplasty: What Options Are Best For Me?
Rhinoplasty, commonly referred to as a nose job, is a surgical procedure designed to change the shape of the nose for either aesthetic or functional reasons. As a key procedure within the broader field of facial plastic surgery, rhinoplasty addresses both cosmetic and medical concerns related to facial appearance. This procedure requires a high level of expertise and precision, often necessitating the skills of a specialist in cosmetic surgery. Rhinoplasty is typically performed in a specialized clinic setting, making it important to choose a reputable clinic that offers modern facilities and comprehensive care for optimal results. Consulting with an experienced cosmetic surgery specialist is crucial to achieving the desired aesthetic results and ensuring the procedure is performed safely and effectively. There are two main types of rhinoplasty: open and closed. Each type has its own set of techniques and benefits, which should be discussed with your surgeon to determine the best approach for your specific needs.
Understanding Rhinoplasty Surgery
Rhinoplasty surgery, is a sophisticated procedure designed to enhance both the appearance and function of the nose. This surgery involves reshaping the nasal structure, which includes the bones, cartilage, and skin, to achieve a more harmonious and functional nose. People opt for rhinoplasty for various reasons, such as correcting breathing issues, refining the shape and size of the nose, and improving overall facial aesthetics.
There are two primary types of rhinoplasty: open and closed. Open rhinoplasty (also known as the open approach) involves making a small incision across the columella, the narrow strip of skin between the nostrils, along with incisions inside the nostrils. This method provides the surgeon with better visibility and control, making it suitable for complex cases or those requiring significant structural adjustments. The open approach offers advantages over other techniques, especially in complex or revision cases, due to its improved visualization and precision. On the other hand, closed rhinoplasty involves making all incisions within the nostrils, avoiding any external cuts. This approach is often preferred for simpler cases or those needing minimal modifications, as it leaves no visible scars.
Anatomy and Physiology of the Nose
The nose is a complex and intricate structure composed of bones, cartilage, soft tissue, and skin. The soft tissue envelope covers and shapes the underlying nasal framework, playing a key role in both appearance and surgical manipulation. At its core lies the nasal septum, a thin wall of cartilage and bone that separates the two nasal passages and provides structural support. The underlying bone and cartilage framework are essential for maintaining the nose's shape and stability. The nasal tip, formed by the lower lateral cartilages, is the most prominent part of the nose, and adequate tip support is critical for preserving both the aesthetic contour and functional integrity of the nasal tip, especially in surgical planning. The nasal skin, varying in thickness and texture, covers the entire nasal structure.
A deep understanding of the nose’s anatomy and physiology is crucial for successful rhinoplasty surgery. Surgeons must have a comprehensive knowledge of the nasal structure and its functions to make precise modifications and achieve the desired outcomes. A thorough examination, including nasal palpation and inspection, is essential to determine the best surgical approach and ensure optimal results.
Indications for Nose Surgery
Rhinoplasty surgery is performed for a variety of reasons, including:
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Correcting breathing difficulties caused by a deviated septum or nasal valve collapse
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Enhancing the shape and size of the nose, including making the nose smaller for patients who desire a more refined appearance
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Reshaping the nose to achieve better facial harmony
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Improving overall facial appearance
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Correcting nasal deformities or abnormalities
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Enhancing nasal function and airflow
A detailed evaluation of the patient’s medical history, nasal structure, and aesthetic concerns is necessary to determine if rhinoplasty surgery is the most appropriate treatment. This comprehensive assessment helps ensure that the surgery addresses both functional and cosmetic issues effectively.
What is a rhinoplasty and which nose operation is best for me?
The nose is reshaped, corrected, or rebuilt during a rhinoplasty (‘nose job’) treatment to attain more aesthetically acceptable proportions and to improve one's physical appearance.
Only after puberty does the nose take on its final shape, which is completed around the age of 16. Generally, rhinoplasties can take place from 18 years of age, although many are undertaken in the 20’s and 30’s and older.
Popular reasons for a nose job are for cosmetic reasons, wanting to change the look so it is more in keeping with the shape of the face, it can also be used to improve function by correcting breathing problems and alleviating the symptoms of sleep apnoea and snoring. In these circumstances, the plastic surgeon will conduct a septoplasty or submucosal resection on the septum or turbinate that are restricting the airway.
The size and shape of the nose, as the most prominent feature of the face, is a major determinant of how we feel about our overall look and attractiveness. If you are unhappy with it for whatever reason, be it a hump or bump on the nose, or tip of the nose you don't like, then a rhinoplasty treatment is the most effective way to improve it.
Depending on the work required, patients will often have either an open or closed rhinoplasty. What is the difference between the two procedures, and which one is best for you?
Open vs closed Rhinoplasty?
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Open rhinoplasty: An open rhinoplasty is a more invasive nose surgery that is performed on patients who require more significant nose reshaping or reduction. The nose surgeon will make incisions at the base of the nostril or between the nostrils, specifically in the columella, which is the skin between the nostrils. Following the incisions, the skin is raised up to enable access to the inside of the nasal cavity for contouring. In many cases, cartilage grafts—often harvested from the septum—are used during open rhinoplasty procedures to provide structural support, correct deformities, or enhance nasal tip contouring and dorsal augmentation. This method, known as the open rhinoplasty technique, is used to address both cosmetic and functional issues of the nose. Open rhinoplasty is often performed under general anaesthesia, especially in a hospital setting for more complex cases, to ensure patient comfort and precise surgical manipulation. It highlights the complexity and the surgeon’s need for a deep understanding of nasal anatomy. The columella will be sutured after the procedure is completed, and the nose will be taped and splinted in place. The splint will keep the nose in place while it heals, and it will be removed in about a week. Patients with genetic or structural defects, injuries to the nose needing grafting, or disappointing results from a previous nose job will benefit from open rhinoplasty.
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Closed rhinoplasty: The most prevalent type of nose surgery is closed rhinoplasty. Because all the incisions are made inside the nose, this type of rhinoplasty leaves no visible scars. Closed rhinoplasty involves making an incision through the mucosa of the interior of the nose rather than across the skin of the columella between the nostrils. Because the surgeon does not have a clear view of the nasal skeleton, this is a technique best left to the more skilled surgeon.
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Which is better: A closed rhinoplasty leaves no external scars, minimises the risk of nose discomfort, and is a less intrusive procedure. As a result, compared to an open rhinoplasty, a closed rhinoplasty has a faster recovery period. Patients who want more substantial work to modify, to correct a previous nose job or shrink their nose will need an open rhinoplasty. In short, neither operation is ‘better’; it simply relies on the individual’s needs and the surgery’s desired goal. An experienced plastic surgeon will be able to explain why they feel it is better to have an open or a closed rhinoplasty. Understanding the differences between open and closed rhinoplasty, including the surgical techniques involved, helps in making an informed decision.
What about a Preservation Rhinoplasty?
Preservation Rhinoplasty is a procedure that avoids destroying or reconstructing the dorsum of the nose during surgery. Internally, the hump of the nose is carefully minimised, allowing the nose to shrink. The purpose of this approach is to keep the nasal ligaments intact while manipulating the cartilages with the smallest possible incisions.
The key advantages of this new surgery are that it is a less intrusive and traumatic operation for the patients, with less swelling and bruising. Even while there is a decreased risk of requiring a revision rhinoplasty with this method, if one is required, the revision can sometimes be easier because there is less scar tissue than with traditional rhinoplasty approaches.
Patients can achieve natural results with Preservation Rhinoplasty, and because of the quick recovery, they can return to their normal routine sooner.
Patients can breathe freely after a preservation rhinoplasty since the risk of post-operative bleeding is decreased. This is due to the procedure's less intrusive nature.
Preparing for Surgery
Preparing for rhinoplasty surgery is a crucial step in ensuring a smooth experience and achieving the best possible results. Whether you are considering open rhinoplasty surgery or closed rhinoplasty, your journey begins with a comprehensive rhinoplasty consultation. During this meeting, our GMC Specilaist Registered plastic surgeon will carefully assess your nasal form, including the nasal skin, nasal bone, and underlying nasal bones, to determine the most effective surgical techniques for your individual needs. This evaluation is essential for both cosmetic surgery and reconstructive surgery, especially if you are seeking to address breathing difficulties, a deviated nasal septum, or other functional concerns.
Your surgeon will discuss your goals for your nose job, explain the differences between open and closed rhinoplasty, and help you set realistic expectations for your new shape. If you have a history of excessive bleeding, allergies, or other medical conditions, be sure to share this information during your consultation, as it may influence the surgical plan and anaesthesia options. In some cases, local anaesthesia may be recommended to minimize discomfort during the procedure.
What to Expect During a Rhinoplasty Procedure
Rhinoplasty surgery is typically performed in an outpatient setting and can take anywhere from one to three hours to complete. The procedure involves several key steps:
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Anaesthesia: To ensure comfort during the surgery, the patient is administered general anaesthesia, local anaesthesia, or intravenous sedation.
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Incisions: Depending on the type of rhinoplasty, the surgeon makes either open or closed incisions to access the nasal structure.
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Modification: The surgeon then modifies the nasal structure, including the bones, cartilage, and skin, to achieve the desired results.
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Closure: After the modifications are complete, the incisions are closed, and the nasal structure is supported with a splint or cast.
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Recovery: The patient is taken to the recovery room, where they are monitored for any possible complications and provided with post-operative care instructions. Swelling and bruising may persist for several weeks, and most patients can return to normal activities after a few weeks. Ongoing nasal refinement and reduction in swelling can continue for weeks or even months.
Following the surgeon’s post-operative care guidelines is essential for proper healing and minimizing the risk of complications. This includes attending follow-up appointments, avoiding strenuous activity during the recovery period, and taking prescribed medications as directed. Patients should keep their head elevated while sleeping to reduce swelling, and proper head positioning during recovery is important to optimize healing.
So which rhinoplasty method is best for me?
To find out which nose surgery procedure is best for you call 0204 551 4892 to arrange a consultation with one of our specialist registered plastics surgeons or fill in the contact form.
In the consultation, your surgeon will show you before and after photos, discuss the procedure options and explain the recovery process. Your surgeon will discuss the type of nose you are looking to achieve. Our nose plastic surgeons have carried out thousands of rhinoplasties and will explain in detail what is best for you, along with the estimated recovery time. Preoperative evaluations are crucial to assess the nasal form and consider any anatomical factors that may influence the surgical approach.
To find out about our expert GMC registered nose surgeons, our 5 star hospitals and quality care, and why we work so very hard to achieve our values click here.