If you’re considering an operation on your nose, known in medical terms as a rhinoplasty, it’s a good idea to inform yourself about the different types of nose surgery so that you can make the right decision for your health and desired appearance. Nose surgery can be divided into two groups, open rhinoplasty and closed rhinoplasty. Each has a series of benefits and risks that you should carefully consider before scheduling an operation.

Consider the details about each procedure as well as the benefits and risks involved to form questions for your next medical consultation.

Open Rhinoplasty

The primary difference between the two types of nose surgery is that open rhinoplasty involves a small incision on the columella, which is the piece of soft tissue between the nostrils, while closed rhinoplasty does not. Although it may seem like a small distinction, this incision significantly changes how the surgeon performs the operation and thus represents an important factor in deciding between the two types of nose surgery.

About the Procedure

Prior to the Procedure

If you decide to undergo an open rhinoplasty, you will need to consult with your surgeon to prepare for the procedure. During this consultation, your surgeon will evaluate your medical history, perform a physical examination and give you instructions for the time leading up to the operation. These instructions may include that you avoid certain medications and that you stop smoking and drinking alcohol. Additionally, it will be important that you arrange for a responsible companion to be at home with you for at least the first 24 hours after your surgery.

During the Procedure

As for the procedure itself, most open rhinoplasties follow a similar series of steps, the first of which is pain prevention. Depending on what you and your surgeon decide is best for you, you will receive either general anesthesia or local anesthesia and sedation.

Once your safety and comfort are ensured, your surgeon will start the procedure by making an incision across the columella and then proceed to reshape the nose. The details of the latter step depend heavily on your condition, as a more complex and technically demanding rhinoplasty will require more time. If your rhinoplasty is meant to correct a minor issue, your surgeon may need only half an hour to reshape your nose. Most rhinoplasties, however, take between one and four hours.


When your operation is finished, you will wake up in a recovery room. You will likely experience some pain, but it should be manageable with oral medication. Within roughly the first 72 hours after the operation, you should notice the pain and discomfort starting to subside, although there will still be bruising and swelling.

Your dressings and splints will be removed after about five to seven days, after which point your nose’s stiffness and soreness will gradually go away. After three or four weeks, you should be recovered from the effects of the surgery itself, although it can take up to a full year for all of the swelling to dissipate. The most important thing you can do to ensure a fast and comfortable recovery is to follow your surgeon’s advice on how to protect your nose while it heals.

Benefits and Risks

Like each of the two types of nose surgery, open rhinoplasty carries both benefits and risks that should weigh on your final decision.


First are the benefits, which are directly related to the open rhinoplasty’s defining characteristic, the columella incision. The columella incision allows the surgeon to directly visualize the operative area, which not only makes the operation easier for the surgeon, but also allows for much more control and precision in how the nasal shape is manipulated.


On the other hand, because open rhinoplasties involve an additional, external incision, there is slightly more swelling. Nonetheless, the scar heals exceptionally well in most cases, and patients generally find it more important to see their final result just as they want it.

Closed Rhinoplasty

Closed rhinoplasty involves no external incisions. Although this is an important difference, the objective and the majority of the details of both procedures remain the same. Both procedures involve reshaping the nose, but the lack of external incisions in a closed rhinoplasty procedure reduces the visibility your surgeon has while operating.

About the Procedure

In practice, the two types of nose surgery are almost identical except for the columellar incision. The preoperative protocol, the operation itself and the recovery process are the same aside from a few details. For example, because a closed rhinoplasty involves one less incision than an open rhinoplasty, the operation usually takes less time. The lack of a columellar incision also causes slightly less swelling during the recovery process. During the operation itself, however, your surgeon will have less visibility and your nose will be more difficult to manipulate.

Benefits and Risks

The balance between the benefits and risks of a closed rhinoplasty centers around the procedure’s lack of a columellar incision. One less incision generally means a slightly faster operation and slightly less swelling during the recovery. However, without an external incision, your surgeon will have less control and precision with which to shape your nose.

Speak With Your Surgeon

The practical difference between the two types of nose surgery is minor, but its implications are important. Open rhinoplasty allows your surgeon to alter your nose’s shape with more control and precision, while closed rhinoplasty means a faster operation and less swelling during your recovery. Talk with a qualified surgeon to decide which type of nose surgery better suits your goals.

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Dr. Winters

About Dr. Winters

Dr. Winters specializes in primary, revision, reconstructive, functional and teenage rhinoplasty surgeries. Dr. Winters is a fellow of the American College of Surgeons and maintains active memberships in the American Society of Plastic Surgeons, the American Society for Reconstructive Microsurgery and others.