What Is the Difference Between Open and Closed Rhinoplasty?

posted on:
June 22nd, 2020
posted by:
Dr. Thomas Bell, MD


People decide to undergo rhinoplasty for several reasons.

Some don’t like the prominent bump on their nasal bridge, some have an unwanted bulbous tip, an over-projected nose, or a nose that is too long and others want to rectify long-standing breathing difficulties.

A rhinoplasty corrects aesthetic imperfections by altering the size and shape and can also be used to resolve nasal breathing issues.

If you’ve looked into your options for rhinoplasty surgery, you’ve likely come across the two different rhinoplasty techniques: open and closed (also called external and internal).

Simply put, the two rhinoplasty approaches are there to cater to the different nasal anatomical features and the results desired. For example, if surgery is being performed to rectify breathing difficulties, a different technique will be required to a patient who wants their nasal tip realigned.

So, which is the right type of rhinoplasty for your needs?

Open Vs. Closed Rhinoplasty: Which Technique Is Best?

Before we dive into which technique is best for your rhinoplasty, patients need to understand how each approach works.

A closed rhinoplasty (aka endonasal, or internal nose job) was the first method of nose surgery and involves small incisions inside the nasal lining which allows alterations through the nostrils, without lifting back the skin. Conversely, an open rhinoplasty, is more modern and difficult and involves a small incision on the columella – the outside skin that separates the nostrils – to allow the surgeon to lift the skin of the nose off the tip, like lifting the hood of a car to work on the engine. The open rhinoplasty allows your surgeon unparalleled access to the underlying bone and nasal tip cartilage.

It’s impossible to provide a one-size-fits-all answer to the question “which technique is best?” – each technique has its own set of benefits that are better suited to certain scenarios. Below, we examine which scenarios fit with which technique.

Open Rhinoplasty

An open rhinoplasty (also known as external rhinoplasty) involves a small incision made at the base of the nose. From here, the nasal skin is lifted above the tip cartilage structure, allowing for better visualization, access and more significant reshaping and structural graft support capacity.

This technique is recommended for patients who want to change the size of their nose, a prominent dorsal hump removed, nasal tip corrected, or reverse the results with a revision rhinoplasty.

Pros & Cons of Open Rhinoplasty

  • Better access to the nasal structure which allows for more reshaping possibilities.
  • The surgeon has greater control and precision.
  • Facilitates reshaping of the nasal tip through intricate suturing or grafting.
  • Lengthier procedure with a longer recovery period.
  • A small scar might remain on your nasal columella (a problem mainly incurred by less-skilled surgeons).
  • More swelling and edema of the nasal tip.

Closed Rhinoplasty

Closed rhinoplasty (also known as internal rhinoplasty) involves making incisions inside the nose through the lining by working through the nostrils. The less-intrusive method is most commonly used to address concerns regarding obstructed airways, minor tip problems, or reducing a bridge bump.

While this technique does have its uses, it isn’t recommended to correct drastic changes or intricate work on the nasal tip. Because of the narrow surgical openings, visibility and access to the underlying nasal structure are limited.

Pros & Cons of Closed Rhinoplasty

  • A simpler and less invasive procedure meaning less swelling and bruising post-procedure.
  • Shorter recovery period for patients.
  • The procedure is faster than an open rhinoplasty.
  • Limited changes are possible due to the limited visibility of the nasal structure.

It is not uncommon to combine the open and external approach to correct nasal bridge concerns, such as bumps and aesthetic nasal tip changes.

Which Surgery is Right for Me?

The specialists at Toronto Plastic Surgery are in the best position to help you make the right rhinoplasty choice. Schedule a consultation with us today to find out how our tried and tested techniques work to give you outstanding results.


Posted by:

Dr. Thomas Bell, MD

Dr. Thomas Bell has been one of Canada’s most renowned cosmetic surgeons for 35 years. He prides his excellence on the harmonious balance of vision, aesthetic appearance, and patient care.

More on Dr. Bell

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