Rhinoplasty, also widely known as a "nose job," is a procedure designed to change the size, shape, or proportions of some or all of the nose. Plastic surgeons commonly use one of two techniques to accomplish the surgery: open or closed. 

Open rhinoplasty involves the creation of small incisions inside the nose, as well as another small incision on the columella, which is the small strip of tissue that separates the nostrils and runs from the tip of the nose to the upper lip. This allows the skin covering the nose to be pulled back for immediate visualization of the internal structures. Closed rhinoplasty is performed by creating small incisions on the inside of the nose without the need for any external incisions. 

A closed rhinoplasty features no external incisions, but less access to the structures of the nose that give it shape. An open rhinoplasty has the advantage of giving the surgeon easier access to the soft tissues beneath the skin, allowing or more precise and complete restructuring of the nose to allow for the most complete and nuanced results. An open rhinoplasty does yield a small scar on the columella, though experienced plastic surgeons such as Dr. Unger will work to make the mark as unobtrusive as possible and is usually nearly invisible to the naked eye. 

When it comes to rhinoplasty, Nashville’s Dr. Jacob Unger, and team at Maxwell Aesthetics regularly work with both men and women who not only want to make a change to their profile, but who want to know about the advantages and disadvantages of each approach. 

Open and Closed Rhinoplasty Candidates

 Many factors come into play when determining who is a suitable candidate for an open or closed rhinoplasty.

For closed rhinoplasty, an ideal candidate is someone who needs changes in their nasal walls and nasal dorsum. Also, the candidate must have no history of nasal trauma or previous nose surgeries. 

For open rhinoplasty, the ideal candidate is someone with substantial irregularities of the nasal soft tissues and cartilage. Any necessary rebuilding is performed using various tissue and cartilage grafts, all easily visualized.  

Either method may be employed for someone who is self-conscious about the look of their nose, as well as people who have breathing problems due to irregularities in their nasal structure. 

Open and Closed Rhinoplasty Procedure Details 

Closed rhinoplasty is often used to correct the bridge of the nose. Many people select this option since incisions are made inside the nose and external scarring is avoided. Even though the incisions are hidden, the surgeon still has entry to the nasal interior and can address many cosmetic concerns. 

Open rhinoplasty exposes the nasal bone and cartilage, allowing the surgeon to more accurately shape the cartilage there. Once the procedure is finished, a small scar—less than 5 millimeters from end to end—is left on the bottom of the nose where the incision is sutured for closure. 

In either case, a general anesthetic is used to make the patient more comfortable throughout the procedure and to do so in the safest manner possible. The surgery will be performed in an operating room as an outpatient procedure. 

Rhinoplasty Recovery and Downtime 

A patient’s recovery time depends on the amount of work performed with either open or closed rhinoplasty. There is usually swelling and bruising near the nose and eyes for about two to three weeks after surgery. It is recommended that patients sleep with their head raised, avoid blowing their nose, periodically use a cold compress to avert swelling, and keep bandages clean. Patients can usually return to their typical routine after two weeks of downtime. Vigorous activities should be avoided, and sunscreen should be applied before going outside. Patients who regularly wear glasses should keep them off for approximately two to four weeks.  

Determining whether the open or closed approach is best should be determined during a face-to-face consultation with the plastic surgeon. 

To learn more about Maxwell Aesthetics and the available rhinoplasty procedures in Nashville, or to get answers to other questions, call 615-932-7700 or visit maxwellaesthetics.com to send a message online.