Top UK Rhinoplasty Surgeon, Julian Rowe-Jones on: What is the difference between open and closed rhinoplasty?

Open and closed rhinoplasty

Closed rhinoplasty is when all the incisions to be used are made inside the nostrils. It’s not so different from open rhinoplasty; in open rhinoplasty many of the incisions used in closed rhinoplasty, inside the nostrils are used, but then they are joined up across the columella, which is a little bit skin between the nostrils and that’s approximately a three millimetre incision.  It’s important that that cut isn’t in a straight line, you get a better plastic surgery result if you use a stair step or a little ‘W’ type incision and that’s what I use.

Experience in both

There are pros and cons of each and I think it’s really important that when you’re tailoring rhinoplasty to the patient, you choose the best approach that’s right for them and I have experience in both and I think it’s important that your surgeon can perform open and close rhinoplasty. Not everybody can, some are only taught one and don’t know how to do the other. 

 Advantages and disadvantages

There are advantages and disadvantages, as I said earlier. I must say as my practice has progressed, I’ve tended to use open approach more than closed approach because I think I can achieve greater levels of precision and accuracy with the open approach. It does sometimes mean that you get a little bit more swelling, as the nose heals but again, one of the things in such a scenario is that you’re not always using open approach for the same cases you use a closed approach for, you’re comparing apples with pears, so when people say, “well I’m going to heal much quicker with the closed approached,” that might be true but not if you’re doing the same through a closed approach as you do through open approach.