Open vs Closed Rhinoplasty

Open or Closed Rhinoplasty. Which One is Better?

“Do I need open or closed rhinoplasty?”

Both procedures aim to change or enhance the appearance of your nose by sculpting the cartilage, bone, and tissues underneath.

However, the surgical approach or methods used to do so are slightly different. Each with its advantages and limitations. Let’s take a look.

Reasons for an Open or Closed Rhinoplasty

The main goal of a rhinoplasty is to improve aesthetics and function when needed.

Most patients often want to:

  • Narrow the nasal tip by eliminating part of the alar cartilage.
  • Straighten or reduce the nasal bridge.
  • Make the nose smaller.
  • Make the nasal tip more turned-up, narrower, or rounder.
  • Place cartilage grafts to fill certain parts of the nose.
  • Correct the deviations of the nasal septum.
  • Fix flaring nostrils.
  • Smooth out the nose bridge in case of dorsal humps.

Open vs Closed Rhinoplasty

What Is a Closed Rhinoplasty?

Typically, people consider getting a nose job done because they don’t like the type of nose they were born with or to fix and acquire deformity after an accident or previous surgery.

In a closed rhinoplasty surgery, also called endonasal rhinoplasty, two smalls incisions are done along the rim of the inside of the nostrils. Then, through these narrow surgical openings, the bone and cartilage are modified to obtained the desired shape.

This method is highly recommended for patients who need some minor modifications, especially bridge reshaping.

Advantages of a Closed Rhinoplasty

Closed rhinoplasty is far less invasive in experienced hands. There is no scarring since the incisions are in the nose’s interior. Also, it is faster with less recovery time!

Additionally, it has the advantage of less swelling of the nasal tip because external incisions do not disrupt the circulation in the area.

Disadvantages of a Closed Rhinoplasty

Essentially, the closed rhinoplasty is a blind procedure, and as such, it presents some technical disadvantages.

Since there is limited access and view of the nasal framework, this could imply less precision. Also, it is difficult to assess the nose’s natural state because there is some distortion of the cartilage and stretching of the skin.

For those reasons, although less invasive, closed rhinoplasty is not used for reconstruction or complex nose surgery. It is frequently indicated in primary rhinoplasty with minor changes.

What Is an Open Rhinoplasty?

During open rhinoplasty, the surgeon makes a third small incision approx. 4-5 mm wide, along the soft skin between the nostrils (columellar incision).

This incision connects with the right and left nostril incisions mentioned above. This allows for the skin of the nose to be lifted, much like a car hood, exposing the lower nasal structures.

The open rhinoplasty procedure is indicated for more intricate surgeries since it allows to do modifications of the septum, remove humps from the dorsum, and work the tip of the nose and nostrils. Also, this approach is essential in case of revision rhinoplasty or reconstructive surgery!

Advantages of an Open Rhinoplasty

The huge advantage of open rhinoplasty approach is that it gives better access to the nasal structures. With an excellent vision of the nasal framework, the surgeon can take the time to analyze the anatomy and make better decisions. Accuracy and precision at the most!

Also, the plastic surgeon could be able to determine and fix abnormalities only seen after the unveiling of the nose and perform advanced cartilage grafting techniques.

This leads to better stabilization of the nasal structures and more definite long-term changes that could endure the natural process of aging. Also, open rhinoplasty approach is far well known and practiced by most surgeons.

Disadvantages of an Open Rhinoplasty

Open rhinoplasty is an invasive approach with more incisions. It involves lifting the skin and then pulling it down, which could lead to visible scarring and more swelling.

However, most plastic surgeons say that by doing a precise realignment of the skin when suturing the columellar incision, the scar can be nearly invisible! You could only notice it when the patient tilts the head back.

Also, the open rhinoplasty takes more time in the operation room and has a slower recovery period.

The Place Where the Science Meets the Art!

Doing a nose job is not as easy as it sounds. It involves a careful evaluation by the surgeon and unparalleled surgical skills.

Also, the plastic surgeon needs to have a good sense of the aesthetic, considering the patient’s wishes, plus good decision-making. They have to combine knowledge with the art in sculpting the cartilage and bone to the desired form.

It is a cosmetic procedure, for sure. Still, it is also essential to maintain or reestablish the structures of the nose. So, it is art and beauty, but it is also science and functionality!


Many surgeons believe that the benefits in precision and accuracy given by the open approach far outweigh the possible scarring and swelling features of the closed one.

However, when choosing the method, the surgeon’s experience, the nasal structure, and the patient’s wishes play a major role.

Every nose job is different, and both methods are equally effective! Ultimately, the surgeon will explain the procedure and discuss the advantages and downsides in greater detail, depending on your particular case.

First, choose your surgeon, then focus on the technique!


Doctor Jesús Benito masters several surgical techniques which allow him to achieve the best results in nose deformities. Some of his techniques have been presented in different scientific publications and at international congresses.

With more than 20 years of experience, Antiaging Group Barcelona is a leading clinic in Spain in rhinoplasty.

Doctor Jesús Benito Ruiz is a recognised authority in Spain in plastic, reconstructive and cosmetic surgery.

Doctor Jesus Benito - Plastic Surgeon

Doctor Jesús Benito

Specialist in plastic and cosmetic surgery.

  • Secretary of the ISAPS (International Society of Aesthetic Plastic Surgery).
  • Former president of the Spanish Association of Aesthetic Plastic Surgery (AECEP).
  • 2013 Gold Medal (Forum Europa)

More information about the medical team.

Bibliography & Publications:

  • Yoon T, Benito-Ruiz J, Garcia-Diez E, Serra-Renom JM. Our algorithm for nasal reconstruction. J Plast Reconstr Aesthet Surg. 2006;59(3):239-47.
  • Benito-Ruiz J, Raigosa M, Yoon TS. Columella Reconstruction Using a Free Flap From the First Web Space of the Foot. Ann Plast Surg. 2012 Sep; 69(3):279-82
  • Rinoplastia Estética Endoscópica. Diseño de un bisturí para el dorso cartilaginoso”. VII Congreso Nacional de la Sociedad Española de Cirugía Plástica Reparadora y Estética. Santiago de Compostela, 7-10 Junio, 1995
  • “Alternativas Terapéuticas en la Reconstrucción Nasal”; Comunicación Oral; XXXVIII Congreso de la SECPRE.
  • Algoritmo de reconstrucción nasal. XLV Congreso de la Sociedad Española de Cirugía Plástica, Reparadora y estética. Girona, 27-28 de mayo de 2010.

Do you want more information about open and closed rhinoplasty?

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    Dr Benito and Dr Salvador - Antiaging Group Barcelona

    Antiaging Group Barcelona

    Ronda del General Mitre, 84, 08021 (Barcelona, Spain)

    Nearest Metro Stations: Les Tres Torres / La Bonanova

    Cosmetic and plastic surgery in Spain | AGB | Dr Jesús Benito