Open vs. Closed Rhinoplasty in Memphis, TN
Rhinoplasty can change the size, shape, proportions, or structure of the nose while also addressing breathing problems. One of the most important decisions in planning surgery is whether to use an open or closed rhinoplasty approach.
Open rhinoplasty uses a small external incision between the nostrils to provide broad access to the nasal framework. Closed rhinoplasty is performed entirely through internal incisions. Both techniques can produce natural, lasting results, but each offers different advantages depending on the anatomy and the changes being made.
At The Langsdon Clinic in Germantown, Dr. Phillip R. Langsdon has extensive experience with both open and closed rhinoplasty and has spent decades refining his approach to nasal surgery. A former president of the American Academy of Facial Plastic and Reconstructive Surgery, he has published innovations in rhinoplasty technique and trained other surgeons in advanced nasal surgery.
He is joined by Dr. Sarah E. Langsdon, who completed a six-year integrated plastic surgery residency at the University of Missouri, followed by a yearlong fellowship in facial aesthetic surgery. Together, they approach rhinoplasty with careful attention to nasal structure, breathing, facial proportion, and the individual changes each patient wants.
Contact The Langsdon Clinic or call (901) 755-6465 to schedule your rhinoplasty consultation in Memphis, TN.
Quick Links:
- What Is the Difference Between Open and Closed Rhinoplasty?
- What Is Open Rhinoplasty?
- What Is Closed Rhinoplasty?
- Is Open or Closed Rhinoplasty Better?
- When Is Open Rhinoplasty Usually Recommended?
- When Can Closed Rhinoplasty Be a Good Option?
- Does Open Rhinoplasty Leave a Visible Scar?
- Can Both Open and Closed Rhinoplasty Improve Breathing?
- Can Open or Closed Rhinoplasty Correct a Crooked Nose?
- Can Cartilage Grafts Be Used During Rhinoplasty?
- How Do Our Surgeons Decide Between Open and Closed Rhinoplasty?
- Can Preservation Rhinoplasty Be Performed Through an Open or Closed Approach?
- What Happens During Open or Closed Rhinoplasty Surgery?
- Does The Langsdon Clinic Use Nasal Packing After Rhinoplasty?
- What Is Recovery Like After Open or Closed Rhinoplasty?
- Why Choose The Langsdon Clinic for Open or Closed Rhinoplasty?
- Schedule a Rhinoplasty Consultation in Memphis
- Open and Closed Rhinoplasty FAQs
What Is the Difference Between Open and Closed Rhinoplasty?
The main difference is where the incisions are made and how the surgeon accesses the nose’s cartilage and bone.
- With open rhinoplasty, your surgeon makes a small incision across the columella, the narrow strip of skin between the nostrils. They can then elevate the skin to improve visibility and access to the nasal framework.
- Closed rhinoplasty uses incisions entirely inside the nostrils. It leaves no external incision, and more nasal soft-tissue attachments can remain undisturbed.
Neither approach is inherently better; the right technique depends on the patient’s anatomy, the complexity of the changes, prior surgery, breathing function, and the surgeon’s ability to achieve the desired correction through a particular approach.
What Is Open Rhinoplasty?
Open rhinoplasty provides direct exposure of the nasal cartilage and bone through a small incision beneath the tip of the nose.
This wider access can be especially useful when the surgeon needs to make significant structural changes or work precisely with the nasal tip.
Open rhinoplasty may be recommended to:
- Straighten a significantly crooked or asymmetric nose
- Reconstruct or reshape a distorted nasal tip
- Make substantial changes to tip projection or rotation
- Place structural cartilage grafts
- Correct more complex nasal deformities
- Address certain breathing problems
- Perform revision rhinoplasty after previous nasal surgery
The external incision is placed in the columella, where the resulting scar generally becomes difficult to notice after it has healed.
What Is Closed Rhinoplasty?
Closed rhinoplasty, sometimes called endonasal rhinoplasty, is performed through incisions placed entirely inside the nostrils. The surgeon works through these internal incisions to reshape cartilage and bone without creating an external columellar incision.
Closed rhinoplasty can address many common changes, including reducing a nasal hump, changing the nose’s length or overall size, refining the tip, and correcting certain internal structural problems.
Because it disturbs less nasal skin and supporting tissue, closed rhinoplasty may also result in less early swelling and a somewhat faster initial recovery in appropriately selected cases.
Is Open or Closed Rhinoplasty Better?
Neither approach is best for every patient.
The better approach gives the surgeon enough access to make the necessary changes while preserving healthy nasal structure whenever possible.
A closed technique may be a good choice when the desired correction can be performed safely and predictably through internal incisions. Open rhinoplasty may be preferable when greater exposure is needed to straighten, reconstruct, graft, or substantially reshape the nasal framework.
A surgeon experienced with both techniques isn’t limited to one method for every nose. Our surgeons have a diverse surgical toolbox and can approach rhinoplasty in the way that suits each patient.
When Is Open Rhinoplasty Usually Recommended?
Open rhinoplasty is often useful when the nasal anatomy is complex or extensive structural work is required.
A severely crooked nose, significant asymmetry, complex tip deformity, major structural weakness, or previous rhinoplasty can make the additional visibility of an open approach valuable.
The technique also lets Dr. Phillip Langsdon or Dr. Sarah Langsdon see the underlying nasal framework directly while placing sutures or cartilage grafts.
For this reason, open rhinoplasty is commonly used for more complex revision cases.
When Can Closed Rhinoplasty Be a Good Option?
Closed rhinoplasty can be appropriate when the planned changes can be accomplished effectively without fully exposing the nasal framework.
Dr. Phillip Langsdon has used the closed approach for procedures involving hump reduction, nasal shortening, tip refinement, reduction of overall nasal size, and selected internal structural corrections.
The absence of an external incision is one advantage, but the decision should not be based on the scar alone. The priority is choosing an approach that allows the surgeon to make the necessary corrections accurately.
Does Open Rhinoplasty Leave a Visible Scar?
Open rhinoplasty requires a small incision across the columella between the nostrils.
Since its location is underneath the nose, the incision is relatively inconspicuous even during healing. With proper closure and normal healing, it generally matures into a fine line that is difficult to see in everyday face-to-face interactions.
Closed rhinoplasty does not require this incision because all surgical access is through the nostrils.
Can Both Open and Closed Rhinoplasty Improve Breathing?
Yes. Either approach can address certain structural problems that affect airflow.
Breathing problems can result from a deviated septum, abnormal bone or cartilage, prior trauma, structural weakness, or narrowing of the nasal airway.
The choice between open and closed surgery depends on the cause of the obstruction and how much access is needed to correct it.
When cosmetic and functional concerns occur together, our surgeons can address both in the same surgical plan.
Can Open or Closed Rhinoplasty Correct a Crooked Nose?
Both techniques can improve nasal asymmetry, but significantly crooked or structurally complex noses often require the additional access open rhinoplasty provides.
A crooked nose may involve the nasal bones, cartilage, septum, or all three. Previous trauma can further complicate the anatomy.
The operation therefore must address the structures causing the deviation rather than simply changing the visible surface of the nose.
Can Cartilage Grafts Be Used During Rhinoplasty?
Yes. Cartilage grafts may be used when the nose needs additional support, projection, shape, or structural reconstruction.
When grafting is needed, cartilage may come from the nasal septum. If more cartilage is needed, the ear or rib may also be used.
The need for grafting depends on the existing nasal framework and the changes being performed. It is particularly important in noses that are structurally weak, significantly asymmetric, previously operated on, or being augmented.
How Do Our Surgeons Decide Between Open and Closed Rhinoplasty?
The decision begins with a detailed evaluation of the nose rather than a preference for one technique.
Dr. Phillip Langsdon or Dr. Sarah Langsdon examines the shape and strength of the nasal framework, skin characteristics, tip structure, bridge, septum, airway, previous surgery or injury, and how the nose relates to the rest of the face.
Just as importantly, the surgeon needs a clear understanding of what the patient wants to change.
The recommended approach should provide enough access to make those changes accurately while avoiding unnecessary disruption of healthy nasal structures.
Can Preservation Rhinoplasty Be Performed Through an Open or Closed Approach?
Preservation rhinoplasty describes the philosophy and techniques used to retain healthy native nasal structures by reshaping or repositioning them rather than removing and reconstructing them.
It is separate from the question of whether the nose is approached through open or closed incisions.
Depending on the anatomy and the work required, our surgeons may incorporate preservation techniques into different rhinoplasty approaches. Dr. Phillip Langsdon’s experience with both structural and preservation-oriented rhinoplasty allows the surgical plan to be based on the individual nose rather than a single preferred method.
What Happens During Open or Closed Rhinoplasty Surgery?
Rhinoplasty is usually performed at The Langsdon Clinic’s ambulatory surgical center in Germantown.
For most patients, deep sedation is supplemented with local anesthesia. The surgical steps then depend on the approach and the changes being made. During an open procedure, the surgeon uses a small columellar incision and internal incisions to expose the nasal framework. During closed rhinoplasty, all access is through incisions inside the nose.
Depending on the treatment plan, the surgeon may reduce or reposition bone and cartilage, reshape the nasal tip, remove a hump, straighten the nasal framework, correct septal problems, improve airway structure, or add cartilage grafts for support and contour.
Rhinoplasty generally takes approximately one to two hours, but crooked, asymmetric, previously operated, or substantially deformed noses may require more time.
Does The Langsdon Clinic Use Nasal Packing After Rhinoplasty?
Our surgeons generally do not place traditional packing inside the nose after rhinoplasty.
Instead, they typically take additional time to replace and secure internal tissues with absorbable sutures when appropriate.
Traditional nasal packing can completely obstruct nasal airflow and may contribute to additional discomfort, swelling, and bruising. Avoiding packing when it is not necessary can make the early recovery period more comfortable.
What Is Recovery Like After Open or Closed Rhinoplasty?
Early recovery varies from patient to patient, but most people should plan to take about one week off work, school, and normal social activities.
- During the first week, swelling, bruising, congestion, and tenderness are expected. Keeping the head elevated can help control swelling, and activity should remain limited.
- After about one week, many patients are comfortable returning to office work or school. Much of the obvious swelling and bruising begins to improve during the first one to two weeks.
- During the first two weeks, strenuous activity should still be avoided while the nasal tissues continue healing.
- Over the following months, the nose becomes progressively more refined as residual swelling decreases. Subtle swelling can persist much longer than the initial visible swelling, particularly around the tip.
- Final refinement may take up to a year.
Closed rhinoplasty can produce less early swelling and a quicker initial recovery in selected patients, although the total healing process for either approach continues well beyond the first few weeks.
Why Choose The Langsdon Clinic for Open or Closed Rhinoplasty?
Phillip R. Langsdon, M.D.
Dr. Phillip Langsdon has devoted his career to facial plastic surgery, with rhinoplasty as one of his principal areas of expertise.
He served as president of the American Academy of Facial Plastic and Reconstructive Surgery in 2018–2019 and has published innovations in nasal surgery, taught physicians specializing in facial plastic surgery, and led advanced rhinoplasty education for other surgeons.
His experience with both open and closed rhinoplasty is particularly important because the decision between the two techniques can be made around the individual patient’s anatomy rather than a predetermined surgical preference.
Sarah E. Langsdon, M.D.
Dr. Sarah Langsdon earned her medical degree from the University of Tennessee Health Science Center in Memphis before completing a six-year integrated plastic surgery residency at the University of Missouri.
She then completed a yearlong fellowship with the American Society of Aesthetic Plastic Surgery specializing in facial plastic surgery.
Her extensive surgical training and focus on facial aesthetics complement the rhinoplasty expertise of The Langsdon Clinic, with particular attention to facial proportion, careful planning, and natural-looking outcomes.
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Visit our Before and After Photo gallery to see real patient results at The Langsdon Clinic.
Schedule a Rhinoplasty Consultation in Memphis
During a private consultation at The Langsdon Clinic, Dr. Phillip Langsdon or Dr. Sarah Langsdon evaluates your nose and explains the reasoning behind the recommended surgical approach. Patients receive a surgical plan based on their anatomy and the changes they want, not a standard approach applied to every nose.
Schedule a consultation at The Langsdon Clinic in Germantown or call (901) 755-6465 to discuss open or closed rhinoplasty.
Open and Closed Rhinoplasty FAQs
Open rhinoplasty involves making a small cut on the strip of skin between your nostrils. This gives the surgeon a clear view of the nasal cartilage and bone, which helps with more complex reshaping. In closed rhinoplasty, all cuts are made inside the nostrils, so there is no visible scar. This method is often used for simpler changes and usually means a shorter surgery and recovery time.
It depends on the changes you want. If you need major changes to the bridge or tip of your nose, or if you are having revision surgery or need extra support, open rhinoplasty is often the more suitable choice because it gives the surgeon a direct view. If you only want small changes, like smoothing a small bump or refining the tip, closed rhinoplasty may be a good option. This approach keeps more of your nose’s natural support and avoids an outside cut.
Usually, it is a faint line. In open rhinoplasty, the surgeon makes a small cut across the skin between your nostrils. With careful stitching and good care, this usually heals into a thin, faint line that is hard to notice when talking to someone face-to-face.
Often, yes. Closed rhinoplasty usually causes less swelling and bruising, so you may look and feel ready to go out in public sooner. Open rhinoplasty can take a bit longer to recover from because there is more swelling, but both types take several months for the final results to fully show.
It depends on the complexity of the problem. If your nose is crooked, very uneven, or has a complex septum problem, open rhinoplasty usually gives the surgeon a clearer view to fix these issues. Both open and closed methods can help with breathing problems, but more difficult cases or repeat surgeries are often done with open rhinoplasty for better accuracy. Open rhinoplasty lets the surgeon see the inside structure of your nose directly, which helps with very precise shaping in complicated cases. Closed rhinoplasty can still give natural-looking results, especially when only moderate changes are needed and the surgeon is experienced.
Closed rhinoplasty does not leave a visible scar on the skin between your nostrils because all cuts are inside. People often have less swelling, a shorter surgery, and a faster early recovery, while keeping more of the nose’s natural support.
In open rhinoplasty, the surgeon lifts the skin of the nose with a small cut, which allows a clear view of the tip cartilage. This makes it easier to adjust the shape with stitches or grafts, which is especially useful for complicated tip changes like major rotation, changing how far the tip sticks out, or making the tip more even.
Most people notice a big improvement in their nose once the first swelling goes down in a few weeks, no matter which method is used. However, small changes in the bridge and tip keep improving for six to 12 months after closed rhinoplasty and sometimes up to a year or more after open rhinoplasty, especially at the tip.
An experienced rhinoplasty surgeon evaluates your nose shape, skin thickness, how you breathe, and what you want to achieve before recommending an approach. Surgeons who are experienced with both open and closed rhinoplasty can tailor the plan to your needs, and sometimes use a mix of both methods when appropriate.
Schedule Your Facial Plastic Surgery Consultation
Board-certified facial plastic surgeon Dr. Phillip R. Langsdon is the only surgeon in the Mid-South whose practice is limited to and specialized in cosmetic surgery of the face, nose, eyes, head, and neck. A former President of the American Academy of Facial Plastic and Reconstructive Surgery, Dr. Langsdon has earned unprecedented recognition and praise as one of the best facelift and rhinoplasty plastic surgeons in America.
He is joined by Dr. Sarah E. Langsdon who completed a six year integrated plastic surgery residency at the University of Missouri and an additional fellowship specializing in facial aesthetic surgery.