A Comparative Study of Open Rhinoplasty versus Closed Rhinoplasty

open rhinoplasty versus closed rhinoplasty

Rhinoplasty is a cosmetic surgery which involves re-shaping of the internal skeleton framework of the nose thus rendering an aesthetically appealing nose. In a recent survey conducted by ISAPS- International Society of Aesthetic Plastic Surgery, it was found that nose jobs accounts for almost 9% of total cosmetic surgeries done around the world.

In a conversation with one of the most famous plastic surgeon based in Mumbai, he tells his maximum plastic surgeries are done for the nose.

Rhinoplasty has the ability to transform the overall appearance of the face. But the quandary floating about in the minds of all potential Rhinoplasty patients is whether to opt for a closed or an open surgical procedure.

In this article we will discuss in depth about the two ways in which Rhinoplasty can be achieved successfully and their medical procedure.

Your Questions About Open Rhinoplasty Answered

The Procedure

As the name suggests open Rhinoplasty involves opening of the nasal skin like a flap folded upward which exposes the underneath skeleton framework to the plastic surgeons and gives a direct visual access for further proceedings.

A small connecting incision about 4-5mm called trans-columellar incision connects the left and the right nostril which enables the opening of the nasal skin.

Open Rhinoplasty is also known as external Rhinoplasty.

Key Technical Features of Open Rhinoplasty

  • Although open Rhinoplasty involves an extra trans-columellar incision, it also gives more surgical access in the nasal area to the plastic surgeons. This reduces the deformity caused in the nasal cartilage.
  • The trans-columellar incision is also advantageous because it exposes each element of the skeleton framework of the nose, which allows the surgeons to examine it closely and give a better and bespoke alignment to the nasal framework.
  • Next trans-columellar incision undoubtedly gives a refined surgical access and thus allows for easy transformation of the nasal framework.
  • Lastly connecting all the dots, the plastic surgeon delivers the nose job with an enhanced precision.

About Closed Rhinoplasty

Closed Rhinoplasty is also known as endonasal Rhinoplasty. And again as the name suggests, all incisions are internally done not visible to the patients. Two incisions on each nostril is done internally to get access to the nasal structural framework.

Endonasal Rhinoplasty is a blind surgical process which means the plastic surgeons have no visual access to the nasal structural framework.

The left and the right nostrils of the patient remain disconnected and the plastic surgeon carries out the alignment procedure individually simultaneously one after the other nostril.

The incisions are hidden hence there is no visible scars of any kind. This is probably the only advantage of closed Rhinoplasty over open Rhinoplasty.

Key Technical Feature of Closed Rhinoplasty 

  • Nasal surgical access is very limited in case of closed Rhinoplasty. Thus relocation of the upper nasal skin is not as easy as open Rhinoplasty.
  • One of the major technical difference between open and closed Rhinoplasty is the trans-columellar incision.  Since closed Rhinoplasty does not go for a connecting incision between the left and right nostril the nasal visibility to the plastic surgeon is largely limited. This is cause complications during the procedure sometimes.
  • Accessing the nasal skeleton framework does not come easy and often there is a risk of nasal cartilage distortion.
  • Most nasal alignment correction can be done using the closed Rhinoplasty method. Although a case-by-case study is required before commencing with the procedures.

Scarring Caused in Open Rhinoplasty vs Closed Rhinoplasty

Since open Rhinoplasty involves a small 4-5mm “v” shaped incision called trans-columellar incision, there can be scars after the surgery. But it is not really visible and takes very less time to heal. Probably two-weeks or so.

No other visible scares since all the other incisions are carried out inside the nostril.

Closed Rhinoplasty has no visible scares since all the incision is done inside the nostril.

Recovery time of Open Rhinoplasty vs Closed Rhinoplasty

Open Rhinoplasty has a longer recovery time as compared to closed Rhinoplasty since the degree of correction and alignment done in open Rhinoplasty is greater than closed Rhinoplasty.

Cost Difference between Open and Closed Rhinoplasty

Although there is not much difference in the cost of the two procedures, you can expect open Rhinoplasty to cost a little more than it’s counterpart due to the extra incision made and the excess time consumed in the procedure.


Although this article can be useful in formulating a better understanding about the two procedures, it is strongly recommended that the patient must discuss his case with his plastic surgeon before taking the final call.

Doctors study every case and provide bespoke solution and chose the most suitable procedure for your case. This depends whether you are looking for a nose augmentation or nose reduction, visual Rhinoplasty for aesthetic reasons, and so on.

It can be easily concluded that open Rhinoplasty offers more precision, minimal nasal cartilage distortion, more flexibility for the plastic surgeon, and versatility in dealing with rather complex nasal structural framework.

The choice of Rhinoplasty is subjective and will be governed by your nasal structural framework and your expectations out of the nose-job.

Open Rhinoplasty is the preferred way for fixing complicated nasal structural framework. Ideally it should be preferred for dealing with post-Rhinoplasty accidents, clip-lip Rhinoplasty, poorly contoured nasal anatomy and irregularity.

Closed Rhinoplasty is ideal if you require minimum nasal contouring. For instance a bump on the nose-bridge can be corrected deploying a closed Rhinoplasty procedure.

The decision of your plastic surgeon will be governed by such technical factors, anatomical study of your nose, reasons for opting a rhinoplastic solution for your nose, whether you are trying to address a respiratory problem or provide an aesthetic solution.

About the hospital:

Sai Sanjeevini Multi Speciality Hospitals, a unit of Singapanga Healthcare Pvt. Ltd has been providing health services to the people in need for the last 14 years. This health care organisation combines practical, proven research, cutting edge procedures and state-of-the-art treatment to produce excellent medical and lifestyle outcome for our patients. Our hospital and medical staff provide innovative medical care in a friendly, compassionate, community environment conducive to patient recuperation in a family atmosphere.