An open rhinoplasty is the procedure in which a tiny incision is made across the columella, the vertical strip of tissue that separates the nostrils. Although usually most imperceptible once healed, there will be a small scar where the incision was made. Many surgeons prefer open rhinoplasty particularly for more complicated problems since it affords a clear view and greater access to the underlying structures.

Many doctors opine that this approach is much more predictable and precise in shaping the nose especially the tip since you can see the framework and set everything exactly where you want it to be, thus leaving much less to chance.

While gaining access to the various structures it aids in preserving the structural integrity of the nose upto the maximum. The tip of the nose, one school of thought opines is best handled by open method, under direct supervision.

For secondary cases, especially if the procedure was performed elsewhere, one really needs to see what was done before, thus open technique is preferred.

Now, how is closed rhinoplasty beneficial:

  • All incisions in closed rhinoplasty are confined to the inside of the nose, thus also called endonasal rhinoplasty. This results in no external scarring.
  • With a closed procedure there is no visible scar and the recovery is relatively faster.

"Closed rhinoplasty is a very good operation and is used in many of my primary cases” says Dr Satya Saraswa, a renowned plastic and cosmetic surgeon. The tip of the nose when done by this method eliminates visible scarring and provides greater ease in adding cartilage to the nasal tip,” he adds. 

Now, which is better?
There is no one way that is better. The best method is the one which your surgeon feels will allow him/her to perform all of the necessary steps for the desired result. Thus, after consultation with the patient your doctor tailors each operation to the specific patient. This algorithm in certain cases derives the technique of open rhinoplasty and in some closed procedure.