Open vs. Closed Rhinoplasty: What’s the Real Difference (and Which Is Better for You?)

Patients ask me about open vs. closed rhinoplasty almost every week. It’s one of the most common — and most misunderstood — topics in rhinoplasty. You’ll find a lot of strong opinions online, but the truth is simple:

Neither approach is “better.” Its what your surgeon is good at and can do predictable. Neither open or closed means “good rhinoplasty,” good rhinoplasty can be done both ways. THERE IS NO DOWNTIME DIFFERENCE OR RECOVERY DIFFERENCE WITH EITHER. OUR PATIENTS LOOK AMAZING BY DAY 6 WITH MINIMAL TO NO BRUISING. SEE OUR VIDEOS ONLINE.

In this article, I’ll break down the real differences, the pros and cons of each and why I do open surgery primarily.

What Is Open Rhinoplasty?

Open rhinoplasty uses a small, precise incision across the columella for access. That incision heals beautifully and invisibly in most patient.

What this allows me to do:

  • correct tip position issues and change nasal length precisely

  • correct nostril issues

  • Address asymmetries

  • Strengthen support

  • Reshape the tip with accuracy

  • Correct collapse, over-resection, and deviations

  • Work safely in revision cases

Who benefits most:

  • Revision rhinoplasty patients

  • Noses requiring structural grafting

  • Deviated or asymmetric noses

  • Over-resected or collapsed noses

  • Weak cartilage or thick skin

  • Patients who need their tip position changed

  • patients with very droopy noses

  • Patients wanting maximal stability and refinement

Scar?

The small external incision typically heals extremely well and is barely visible once healed.

What Is Closed Rhinoplasty?

Closed rhinoplasty keeps all incisions inside the nostrils — no external incision.

Who benefits most:

  • Very straightforward cases

  • Patients who dont need much tip change

  • isolated humps but perfect nasal length rotation and projection as well as nostils

The Big Misconception: “Closed = More Advanced” (It’s Not)

There’s a trend online trying to market closed rhinoplasty as a newer or superior method. This is simply not true.

Closed rhinoplasty is useful — but it is:

  • more limited

  • less ideal for precision structural work

  • not suited for complex anatomy

  • not appropriate for any revision cases

  • harder to place grafts reliably

  • harder to control the tip and long-term stability

For any patient who needs strong support, tip refinement, long-term stability, or correction of functional issues, open rhinoplasty is the safer, more controlled, and more predictable approach.

My goals for every patient:

  • stable results

  • natural tip definition

  • strong support

  • breathing optimization

  • symmetry

  • longevity

These are much more reliably achieved with the open approach in my hands.

Bottom Line

Open and closed rhinoplasty are tools — nothing more.
My role is to choose the technique that gives you:

  • the most natural-looking result

  • the best long-term stability

  • ideal function and breathing

  • the safest and most precise approach

  • the shape that harmonizes with your face

A great rhinoplasty is not about the incision —
it’s about the architecture.

Considering rhinoplasty or revision rhinoplasty? Click here to book a consultation with Dr. Hyman.

ARI HYMAN