How Important Is It to Focus On Whether the Beverly Hills Cosmetic Surgeon Performs An “Open Rhinoplasty” or “Closed Rhinoplasty”?

I find patients often get hung up on technical details that have little bearing on the outcome.

Because of attention given to the so-called “open rhinoplasty” in recent years, it seems to have captured the imagination of the public.  The reality is that for over 75 years all nasal surgeries were done by incisions entirely within the nose, the “closed rhinoplasty” approach, and results were generally good. 

I understand the value of an open rhinoplasty as a technique to teach young surgeons but once they have mastered the fundamentals of cosmetic plastic nasal surgery, they should be able also to perform the operation from within the nose.  Yes, it is a bit easier to see the structures of the tip when an external incision has been made and the skin has been lifted up, akin to lifting the hood of a car.  However, there is always some price to be paid when additional incisions and maneuvers are fashioned.  For some people, the scar is visible and that turns out to be a point of dissatisfaction.  There is a slight increase in swelling after surgery and this could translate to longer healing times. 

In my opinion based on nearly 40 years and 4,000 nasal surgeries performed, the great majority of the noses can be satisfactorily done through hidden incisions entirely within the nose, closed with absorbable stitches.