Question : I’d like to have a closed rhinoplasty procedure for my revision rhinoplasty and I was wondering just how much of the decision between open and closed is the patient’s vs. the doctor’s.
Answer : The decision between open and closed rhinoplasty really is based on the degree of deformity and what needs to be corrected. I use both rhinoplasty techniques. Sometimes a closed approach is the most appropriate without any incision in the nasal columella, and sometimes an open approach is the best approach with a small incision in the columella. This incision usually heals well and if this is the best approach, it makes sense to use it. The choice of the incision should not be just a whim or preference. The surgeon should be familiar with both techniques and use the best technique to get the best result available. Sometimes patients are initially afraid of the open approach and the small incision on the columella, but when they see the closed approach may not solve the problem, they’d rather have the small incision which may heal well than having two separate surgeries or having a result that is less than optimal.