Closed Rhinoplasty Surgery

A nose job, or rhinoplasty, can be done in either of two ways, open or closed. In open rhinoplasty, there is an incision on the outside of the nose. In closed rhinoplasty, incisions are made on the inside of the nostrils, where they are hidden. Occasionally, you see the terms external rhinoplasty and internal rhinoplasty for open and closed procedures.

A closed rhinoplasty produces no visible scars. This does not mean that there are no scars, just that they are not visible. Scars are hidden inside the nostrils. The surgeon makes the incisions inside the nostril, with the location within the nose dictated by what needs to be done.

Although the surgeon will manipulate the skin on the nose somewhat so that he or she can see into the incision, the view is not as complete as it would be with an open technique. To some extent, the surgeon cannot see what he or she is doing. This is why not all types of corrections to the nose can be accomplished with a closed technique.

After the surgeon is finished making corrections or changes to the shape of the nose or the septum, the incisions in the nostrils are closed and the nose is packed with absorbent materials. Sutures are usually removed in 3 to 8 days, although some surgeons use absorbable sutures that do not need to be removed.

Some surgeons strongly prefer using a closed technique and others have a strong preference for an open technique. Do not choose a surgeon based on which technique he or she uses or because you fear that the scar from an open technique will be too visible. Scarring from an open technique is very inconspicuous and is well hidden under the nose. If a surgeon tells you that your surgery requires an open technique, listen to his or her reasoning before you make up your mind.

Occasionally, a surgeon may start a rhinoplasty with the intention of using a closed technique and have to switch to using an open technique during the surgery. This may be necessary if a closed technique makes the surgery more difficult than foreseen.

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