There is no simple answer when comparing open and closed Rhinoplasties, which is why rhinoplasty surgeons in Columbus like myself have been arguing about this topic for decades. Most experienced rhinoplasty surgeons were trained to utilize both techniques and know how and when to use each. However, because most rhinoplasties performed these days are done through the open approach, younger surgeons only learn this technique.
At Sullivan Centre, I utilize the open approach for most of my patients primarily because visualization of the cartilage and bone structure of the nose is dramatically improved with the open procedure. When the problem is more easily seen, the correction is inevitably more accurate. I studied this theory in my own practice years ago and found patient satisfaction to be greater with open surgery and more importantly, the need for revision Rhinoplasty surgery in Columbus to be either non-existent or certainly less with this approach.
The argument against open rhinoplasty primarily centers on the external scar in the skin bridge between the nostrils. This is very thin skin and in nearly every case heals with a scar, which is not noticeable in my estimation. Other arguments include prolonged healing, which I have not found to be true and disruption of the delicate detail of the rim of the nostrils. This is a legitimate concern, but avoidable if the surgeon is meticulous about the placement of the incision.
When little or no nasal tip cartilage modification is needed, the closed rhinoplasty is preferred. With the closed technique, the rhinoplasty surgeons’ view of the nose structure is compromised because the only incision for access is inside the nose. Adequate visualization is improved with the use of a headlight and experienced surgeons are used to looking at the nose this way. Each technical change made with the closed approach has to be assessed by feel. This is where experience is so important. The closed approach is perfect for nasal bump removal and for narrowing the nose. It’s however not adequate for most complicated twisted noses, large bulbous nasal tips and major revision cases.
In searching for your Columbus rhinoplasty surgeon, remember first and foremost, EXPERIENCE MATTERS! An experienced surgeon will know which approach, opened or closed, is right for your particular situation.
Read more about this topic and rhinoplasty surgery in Columbus by accessing my book, “When Your Nose Doesn’t Fit” on our website or pick up a complimentary copy at my office, 7706 Olentangy River Rd. Columbus, Ohio, 43235.