Technique Comparison

Closed vs open rhinoplasty: which technique for whom?

Q: Will the open scar be visible forever?

No. With good technique it fades in 6-12 months. In keloid-prone or thick-skinned patients, mild prominence may remain. Closed eliminates this concern.

Q: Is the closed technique less successful?

No — in appropriate cases closed matches open in results. The surgeon's experience is decisive.

Q: Which technique does the surgeon use more often?

Closed in 85-90% of primary cases. Revision and complex cases typically use open.

Q: Can the technique change during surgery?

Yes — some cases start closed and convert to open if needed.

Rhinoplasty has two main surgical approaches: closed and open. Both follow the same plastic surgery principles — the difference lies in how the surgeon accesses the anatomy. Which technique is right for you depends on your anatomy and the magnitude of change you seek.

The core difference: incision location

Closed (endonasal) rhinoplasty

All incisions are made inside the nostrils. The columella (skin bridge between the nostrils) is untouched. Nasal skin is only partially lifted; the surgeon views the anatomy from a limited internal angle.

Open (external) rhinoplasty

In addition to internal incisions, a small incision (usually V-shaped or zigzag) is made on the columella. This allows the surgeon to fully lift the nasal skin — a complete view of the anatomy becomes possible.

Comparison table

Factor	Closed Rhinoplasty	Open Rhinoplasty
External scar	None — no columella incision	Yes — small scar on columella (usually fades)
Visual field	Limited, from inside	Wide, full view
Swelling duration	Shorter (80% resolved in 3-6 months)	Longer (80% resolved in 6-9 months)
Social return	7-10 days	10-14 days
Operative time	1.5-2.5 hours	2.5-4 hours
Tip support	Better preserved	More manipulation
Complex cases	Limited	Preferred
Revision cases	Usually not suitable	Preferred
Surgeon expertise	Requires higher skill	More teachable

Which case uses which technique?

Closed is preferred for

First-time (primary) rhinoplasty
Dorsal hump reduction
Mild-to-moderate tip rotation
Septal deviation (with septorhinoplasty)
Turbinate hypertrophy correction
Patients with soft-to-medium skin thickness
Patients who want no visible scar
Patients prioritizing fast social return

Open is preferred for

Advanced revision cases
Reconstructive cases requiring extensive cartilage grafts
Complex tip deformities
Significant asymmetry correction
Post-traumatic reconstruction
Cleft-lip/palate-related nasal deformities
Cases where closed technique view is insufficient

How the decision is made

The decision rests on three key factors:

Anatomical evaluation: Nasal structure, cartilage quality, septum, skin thickness are examined. Complex cases may require open technique.
Desired change magnitude: Mild-to-moderate refinement can be achieved with closed; aggressive reconstruction needs open.
Revision status: Previously operated noses, due to scar tissue and stiffness, require open approach.

Hybrid approach: In some cases the surgeon starts with closed and converts to open if needed. This is called the "convertible approach." Discuss this possibility with the surgeon before surgery.

How does the scar heal?

In open technique the columella incision is 3-4 mm long and V-shaped. With good surgical technique:

First 2 weeks: pink-red color, slightly raised
1-3 months: color fades, mild prominence remains
6-12 months: imperceptible in most patients
In thick skin or keloid-prone individuals: mild scar may persist

In closed technique no external scar forms at all — this is a permanent advantage.

Frequently asked questions

Will the open scar be visible forever?

No. With good surgical technique the incision becomes imperceptible in 6-12 months. However, in thick-skinned or keloid-prone patients mild prominence may remain. The closed technique eliminates this concern entirely.

Is the closed technique less successful?

No — in appropriate cases the closed technique can match the open technique's results. It is not about which method is "superior"; it is about applying the right technique to the right patient. With an experienced surgeon, both methods produce excellent results.

Which technique does the surgeon use more often?

Doç. Dr. Erdal uses closed technique in 85-90% of primary (first-time) rhinoplasty cases. Revision and complex cases are typically performed with open technique. The decision is individualized for each patient.

Can the technique change during surgery?

Yes — in some cases the surgeon starts closed and converts to open if needed. This is uncommon but should be discussed pre-operatively.

Closed vs open rhinoplasty: which technique for whom?

The core difference: incision location

Closed (endonasal) rhinoplasty

Open (external) rhinoplasty

Comparison table

Which case uses which technique?

Closed is preferred for

Open is preferred for

How the decision is made

How does the scar heal?

Frequently asked questions

Which technique is right for you?