Nose reshaping surgery can be divided into two types of procedures; open (external) rhinoplasty and closed (internal) rhinoplasty.
Briefly, the term open rhinoplasty describes the surgical technique by which an external incision is made in the area between the two nostrils.
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In a closed rhinoplasty all incisions are made within the nasal structure.
It’s a matter of the surgeon’s preference and experience as to which technique he or she uses for a given case.
In an open rhinoplasty the horizontal incision allows for the skin to be lifted to more easily view and gain access to the nose tip cartilage. The plus side of open (external) rhinoplasty is the increased access to certain nasal structures. On the minus side is the small external incision and potential of light scarring.
A closed rhinoplasty is done entirely within the nose with no external incisions. This procedure takes more technical facility and manual dexterity than the open procedure.
Both the open and closed procedures have been used by plastic surgeons for decades.
With an open rhinoplasty the surgeon can directly view the cartilage and other structure within the nose more easily than with a closed approach. He or she can also more easily make changes with more control and precision. Some changes can, in fact, only be completed using the open rhinoplasty procedure.
Open rhinoplasty is usually chosen for more complex procedures such as severely deviated nasal structure, and more complicated nasal deformities such as cleft-lip rhinoplasty.
Other more routine procedures in which cosmetic surgeons may choose open rhinoplasty are treating a bulbous tip, droopy, pinched or projected tip.
Closed rhinoplasty is usually chosen for smaller changes which can be done without the direct access and viewing provided by the incision on the outside of the nose.