Rhinoplasty, or nose job in layman’s term, is either performed through an open or closed technique incision; this allows the surgeon to reshape the cartilaginous and bony framework of the nose to improve its “outside appearance.”
Renowned Los Angeles plastic surgeon Dr. Tarick Smiley says he prefers the closed technique in which the incisions are limited inside the nostril, thus reducing any risk of visible scar. The open rhinoplasty, meanwhile, cuts the columella or wall separating the two nostrils to lift the “roof” of the nose before reshaping the underlying framework.
“About 95 percent of my rhinoplasty is done through closed technique,” Dr. Smiley said in his recent posts on Snapchat that demonstrated two female patients who have had nose-reshaping surgery.
The celebrity plastic surgeon has explained the “core” benefits of closed rhinoplasty:
- More control and increased predictability over the final results
Some surgeons argue that the open technique provides more control over the final results due to the improved visibility since it allows them to raise the roof of the nose. However, Dr. Smiley says it comes with one major caveat: They do not see the “outside appearance” of the nose while they are reshaping the underlying framework.
Meanwhile, the closed rhinoplasty technique allows the surgeon to reshape the underlying framework and see and examine the outside appearance of the nose in “real time.”
“Just like you’re molding a piece of clay it is better to see it every time you do it step by step,” he explained in the videos.
- Shorter recovery
Compared to the open technique, closed rhinoplasty causes less disruption and injury to the soft tissue, leading to less bruising, pain, and swelling, which in turn contributes to shorter recovery.
Contrary to popular belief, most patients are concerned about the “social downtime” than the pain (which in most cases is well controlled by medications). With closed technique, many patients can expect to look presentable after a week, versus 10-14 days when open rhinoplasty is performed.
- No risk of visible scar
With closed rhinoplasty, there is no external scar across the columella. It is important to note that open rhinoplasty often results in barely detectable scar, although a small percentage of patients have experienced less than optimal scar.