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Open VS Closed Rhinoplasty

If you’re researching rhinoplasty and keep seeing the terms “open” and “closed,” you’re not alone. These two techniques have advantages, and board-certified plastic surgeon and Fellow of the American College of Surgeons Dr. Rady Rahban applies them depending on each patient’s unique anatomy and goals.

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Experience Across Techniques

As a member of the Rhinoplasty Society and a recognized authority on intricate nasal procedures, Dr. Rahban brings first-hand experience performing open and closed rhinoplasties, allowing him to give honest, unbiased guidance on the best approach for you.

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Rhinoplasty Basics

A rhinoplasty alters the nose's bone, cartilage, and soft tissue. While it’s often performed for cosmetic reasons—such as refining the nasal tip or removing a hump—this surgery can also address breathing difficulties. Ultimately, it’s about creating a harmonious, functional nose that suits your face without compromising your airways.

Reasons For an Open or Closed Rhinoplasty

Many of Dr. Rahban’s rhinoplasty patients want to correct one or more of the following:

  • A nose that seems too large or too small relative to the face
  • A prominent bump on the nasal bridge
  • A bulbous, drooping, or oversized nasal tip
  • Wide or flared nostrils
  • A crooked or asymmetrical appearance

Both open and closed approaches can address these cosmetic and functional issues. The key differences lie in how your surgeon accesses the nasal structures and the level of visibility each approach offers.

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Changes Made During Rhinoplasty

Regardless of technique, every rhinoplasty involves temporarily lifting the skin to modify nasal bone and cartilage. This is where artistry and precision matter most: Dr. Rahban carefully evaluates your facial proportions and tailors his surgical plan to achieve lasting, natural-looking improvements.

Open Rhinoplasty

How It Works

An open rhinoplasty includes two incisions inside the nostrils and a small incision across the columella (the narrow strip of tissue between the nostrils).

This trans-columellar incision “opens” the nose, granting the surgeon complete visibility of the nasal structures.

Advantages of an Open Rhinoplasty

  • Unparalleled Visibility: Seeing and measuring the underlying anatomy allows for exact work. Dr. Rahban can identify minute asymmetries and subtle abnormalities that may not be obvious externally.
  • Greater Accuracy: Any extra precision can be invaluable because the nose is a delicate, prominent feature. Open rhinoplasty often yields highly refined, durable changes—especially for complex cases.
  • Advanced Grafting Techniques: Dr. Rahban frequently relies on cartilage grafts for long-term structural support. The open approach makes it easier to place these grafts meticulously and ensure optimal stability.

Potential Drawbacks of an Open Rhinoplasty

  • Small External Scar: While there is a tiny trans-columellar scar, it typically heals remarkably well. Dr. Rahban personally closes each incision, and most patients find the scar virtually invisible once fully healed.
  • Slightly More Swelling: An open approach can lead to extra swelling in the early stages of recovery. However, Dr. Rahban believes the benefit of improved accuracy and access far outweighs this temporary effect.

Closed Rhinoplasty

How It Works

A closed rhinoplasty uses incisions entirely within the nostrils—no external incision across the columella. Through these internal entry points, the surgeon adjusts the bone and cartilage.

Advantages of a Closed Rhinoplasty

  • No External Incision: Many patients appreciate that closed rhinoplasty avoids a visible scar.
  • Potentially Less Swelling: In the short term, the closed method may involve slightly reduced postoperative swelling.
  • Ideal for Subtle Adjustments: A closed approach can be quite effective when minimal changes are needed, such as a slight reduction in the bridge.

Potential Drawbacks of a Closed Rhinoplasty

  • Limited Visibility: Since the nose isn’t fully “opened,” certain areas can be more challenging to access. Closed rhinoplasty might not allow enough precision for patients with complex issues—or those wanting more significant changes.
  • Undetected Structural Needs: A seemingly minor cosmetic request still requires detailed structural work. The closed approach may limit the surgeon’s ability to use advanced grafting or thoroughly stabilize the nose for long-term durability.
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Reconstructive vs. Reductive Rhinoplasty

Reductive rhinoplasty often involves removing a bump or reducing an over-projected tip. If the alterations are straightforward, they can be done through a closed approach in select cases.

Alternatively, reconstructive rhinoplasty addresses more complex corrections, such as correcting significant asymmetry, supporting a drooping tip, or rebuilding nasal structures after injury.

This often calls for the open method to maximize visibility and structural work, especially for revision cases where Dr. Rahban’s meticulous craftsmanship is crucial for a successful outcome.

Open vs. Closed Rhinoplasty FAQ

How noticeable is the scar from an open rhinoplasty?

Does skin color affect scar visibility?

How does recovery differ between open and closed rhinoplasty?

Are results better with open vs. closed rhinoplasty?

How noticeable is the scar from an open rhinoplasty?

When closed meticulously, the small trans-columellar incision usually heals to the point of being nearly invisible. The nasal columella is an area known for excellent healing, so many patients and their friends never notice a scar.

Does skin color affect scar visibility?

Skin tone generally doesn’t influence the final appearance of the trans-columellar scar. Proper surgical technique and post-operative care have more impact on scar healing than skin color.

How does recovery differ between open and closed rhinoplasty?

A closed rhinoplasty may result in slightly less initial swelling, but overall recovery timelines are similar. Expect some bruising, congestion, and mild discomfort during the first week, with daily improvements. Individual healing can vary based on the complexity of the surgery and personal factors, such as overall health and adherence to aftercare instructions.

Are results better with open vs. closed rhinoplasty?

When minimal changes are needed, a closed rhinoplasty can produce excellent outcomes. However, an open rhinoplasty offers greater precision and versatility, making it the approach of choice for more detailed or complex cases. Ultimately, the expertise of your surgeon matters more than the specific method.

Choosing the Right Approach

Deciding between an open or closed rhinoplasty shouldn’t be your primary focus at the outset. Instead, it's crucial to choose a skilled, experienced surgeon who can assess your goals, evaluate your anatomy, and determine which technique will produce the safest and most harmonious result. Dr. Rahban’s reputation for meticulous attention to detail, emphasis on patient safety, and transparent communication helps ensure that every procedure—open or closed—meets the highest standard of both form and function.

Schedule a Consultation

When meeting with prospective patients, Dr. Rady Rahban is thorough and honest above all else. He will listen intently to your cosmetic concerns and evaluate whether your desired outcome is achievable, then offer a custom plan to address any structural or aesthetic issues. If you’re ready to discover what’s possible for your nose with arguably the best rhinoplasty Los Angeles has to offer, we invite you to schedule a private, comprehensive consultation with Dr. Rahban. From there, you’ll be on the path toward a well-informed decision—and a beautiful, natural-looking result.

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When Dr. Rahban does a consultation with a prospective patient, he wants it to be two things above all others: thorough and honest. He will find out from you just what you want from cosmetic surgery. And he will tell you honestly if you can get the result you want, and how he can best help you do so.

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