It used to be that a rhinoplasty resulted in a cookie cutter nose — making it easy to identify those who had undergone the procedure. Nose jobs also came with pain, bruising, and days of gauze-packed bandages. But today, a patient has options and, after consulting with a doctor, can choose between an open or closed rhinoplasty. After all — each nose is unique and should be treated as such. So what makes a closed rhinoplasty different from an open one? Here are the basics:
Each technique involves small incisions and close attention to detail. In both a closed and open procedure, a patient will be under general anesthesia. During an open rhinoplasty, a surgeon makes an external incision in the columella. At that point, the nasal skin is folded upward (kind of like the hood of a car), allowing the doctor to operate and correct any deformities. Following the procedure, the nose is stitched up, packed with gauze, and set for healing. In some cases, this might be ideal for complicated procedures and a rhinoplasty that includes a tip revision. During a closed rhinoplasty, all incisions are made inside the nose by entering through the nostril. The surgeon will lift up the skin that covers the nose’s bones and cartilage, and the reshaping begins. After, the internal nose cavity is sewed up and eternally splinted or casted with no packing. With the exception of extreme cases, the procedure typically takes about two hours.
Whether opting for an open or closed nose job, a patient should be prepared for several days of rest following surgery. Open rhinoplasty techniques have improved over the course of the years. Still, they continue to involve an exterior incision. Because of this outward approach, patients can be left with small, but visible, scarring, swelling, bruising and even temporary numbness. Additionally, patients can expect bruising for at least a week, swelling for up to 30 days, and the incision spot to take as long as 12 months to completely heal. Sometimes, a doctor will recommend two weeks off of work for recovery post procedure. In contrast, a closed procedure has significantly less swelling and bruising, and patients are often able to return to work or school after a week to 10 days. While the nose will be sensitive for several days, there will be no visible scabbing in the following weeks, and therefore, no scars in the long run.
Clear and honest consultations with your physician are the best way to ensure satisfactory results. As both techniques continue to improve, this open discussion will be essential to choosing the right procedure for your needs. Neither open or closed rhinoplasties are an “instant fix,” and, in all circumstances, you’ll be most satisfied with a nose that compliments the rest of your face. While you will notice some immediate changes, the results will continually evolve as time passes, leading to an optimal appearance.