Should My Rhinoplasty Be Done Open Or Closed?
Q: Dr. Eppley, I am interested in a rhinoplasty and want to know if it is better to have it done open vs. a closed approach. My nose has a big and wide tip and hump that I want changed. Does one approach offer a better result for my nose?
A: The question of whether a primary rhinoplasty procedure should be done with an open or a closed approach is an historic debate. When it comes to revisional rhinoplasty, there is no debate that an open approach is almost always better depending upon the nasal problem being addressed. But in an unoperated nose like yours (thick skin, bulbous tip, dorsal hump) the operative approach is largely based on surgeon experience and preference. But most rhinoplasty surgeons today would opt for an open approach because it provides a more complete assessment of the structure changes and the prevention of complications that can occur from these structural changes. (middle vault collapse, asymmetries, supratip defomities) Open approaches do tend to have more prolonged tip swelling but that is a small price to pay for a more exacting result long-term. Many patients are concerned about the scar from an open rhinoplasty but an incision is this small strip of skin between the nostrils heals remarkably well and rarely can be ever seen afterward even on close inspection.
Dr. Barry Eppley