Open vs. Closed Rhinoplasty

Open and closed rhinoplasty refer to the 2 different approaches your plastic surgeon may use to access the internal structures of your nose. Open rhinoplasty involves a tiny external incision across the columella, the strip of tissue between your nostrils. Closed rhinoplasty places all incisions inside the nostrils. Both rhinoplasty techniques can create natural-looking, long-lasting results. The right approach depends on your anatomy, goals, and the complexity of the changes being made.

This guide explains the structural and visual differences between open vs. closed rhinoplasty, how each affects surgical access, precision, healing, and scarring, and how your surgeon decides which technique makes the most sense for you.

What Is Open Rhinoplasty?

As mentioned earlier, open rhinoplasty uses a small incision across the columella, along with internal incisions, to lift the nasal skin and provide a clear view of the cartilage and bone underneath.

Our Royal College-certified plastic surgeons may recommend an open approach when they need:

• Maximum visibility and access to the nasal framework
• Detailed tip refinement, especially for a bulbous or drooping tip
• To correct complex issues, such as severe asymmetry or collapse
• To perform more advanced or reconstructive work, such as in revision rhinoplasty

Because the structures are easier to see and manipulate, open rhinoplasty allows for very precise adjustments. The trade-off is a small external incision, which typically heals to a fine, barely noticeable line under the nose.

What Is Closed Rhinoplasty?

Closed rhinoplasty places all incisions inside the nostrils, with no external incision on the columella. The skin is not lifted to the same extent as in open surgery, so visibility is more limited. Still, the approach is often well suited for less complex changes.

Your surgeon may consider a closed approach if:

• You want more modest refinements, such as smoothing a small hump or subtly narrowing the bridge
• Your nasal tip requires only minor adjustments
• This is your first nose surgery with relatively straightforward goals

Closed rhinoplasty can be an elegant option when the anatomy is favourable and the desired changes are limited. For some patients, the appeal is knowing that all incisions are hidden.

How Do Open and Closed Rhinoplasty Differ in Technique?

The main difference between open and closed rhinoplasty is access and visibility:

• Open rhinoplasty gives your surgeon a direct, panoramic view of the nasal framework. This can be especially beneficial for:
  • Complex tip plasty work to refine a bulbous or drooping nasal tip
  • Correcting asymmetry or collapse after injury or previous surgery
  • Advanced work such as revision rhinoplasty or more intricate rhinoplasty techniques
• Closed rhinoplasty provides more limited exposure, which can be ideal when:
  • The nasal framework is generally well-structured
  • Most changes involve the bridge rather than detailed tip reconstruction
  • A shorter operative time and fewer external incisions are preferred

In both approaches, your surgeon reshapes cartilage and bone to support a natural-looking, balanced result. The choice is not about which method is “better” in general, but which one offers the safest, most precise path to your goals.

How Do Recovery and Scarring Compare?

Recovery after open and closed rhinoplasty is more similar than most people expect, but there are a few differences:

• Swelling and bruising
  • Both approaches involve swelling and bruising around the nose (and sometimes the eyes) in the first 1 to 2 weeks.
  • With open rhinoplasty, tip swelling can last longer and take more time to refine fully.
• Incisions and scarring
  • Open rhinoplasty leaves a small incision on the columella that typically fades to a fine, discreet line.
  • Closed rhinoplasty places all incisions inside the nose, so there is no external scar.
• Timeline
  • Most patients return to work or social activities within about 1 to 2 weeks, regardless of approach.
  • Subtle changes and refinement continue for several months, especially at the tip.

Your overall rhinoplasty recovery is guided more by the extent of work performed than by the approach alone. Larger structural changes and revision cases usually take longer to settle, whether done with an open or closed technique.

Who Is a Candidate for Open vs. Closed Rhinoplasty?

You may be a better candidate for open rhinoplasty if:

• You need significant tip reshaping or structural support
• You’re undergoing revision rhinoplasty after a previous procedure
• Your nose has marked asymmetry, collapse, or trauma-related deformity
• You have complex goals that require very fine, three-dimensional adjustments

You may be a better candidate for closed rhinoplasty if:

• Your goals are more limited and focused, especially on the bridge
• Your internal support is strong, with no major structural deficits
• You’re seeking more subtle refinement, and your anatomy is favourable

During your consultation, your surgeon will evaluate your nose from every angle, review your goals, and recommend the approach that offers the best balance of access, precision, healing, and long-term stability.

Choosing the Approach That’s Right for You

Ultimately, the choice between open and closed rhinoplasty should be based on your anatomy, your goals, and your surgeon’s expert judgment, not on trends or assumptions about which technique is “better.”

Your surgeon will:

• Explain why they recommend a particular approach in your case
• Show how it fits into your overall rhinoplasty surgical plan, whether that includes tip-focused work, male rhinoplasty, or ethnic rhinoplasty
• Outline what to expect from your recovery, scarring, and long-term refinement

By working with a team experienced in both open and closed approaches, you can feel confident that your rhinoplasty will be customized to your needs, using the technique that offers the safest, most effective path to a natural-looking result.

Get Started With Rhinoplasty

Find out whether you are a good candidate for rhinoplasty and how our experienced rhinoplasty surgeons can help you achieve your desired look. Request a consultation using the online form or call Ford Plastic Surgery at (416) 925-7337 to set up your appointment.