Dr. Thomas BuonassisiFacial Plastic Surgeon · 8 West Clinic, Vancouver
Published July 2026·Medically reviewed by Dr. Buonassisi
KEY TAKEAWAYS — IN THIS VIDEO
<ul><li>Scarless rhinoplasty is often synonymous with closed rhinoplasty, involving internal incisions.</li><li>Open rhinoplasty includes a small external incision but can also result in minimal visible scarring.</li><li>Preservation rhinoplasty focuses on maintaining nasal structures and can be performed with either incision type.</li><li>The choice between open and closed rhinoplasty should be guided by the surgeon's expertise for optimal results.</li><li>Both techniques aim to achieve a natural appearance and improved nasal function.</li></ul>
Dr. Buonassisi · Closed vs Scarless Rhinoplasty Explained
Dr. Thomas Buonassisi, FRCSC, ABFPRSAuthor · Reviewer
Facial Plastic Surgeon · Founder, 8 West Clinic · Vancouver, BC
Dr. Buonassisi is a dual board-certified facial plastic surgeon with over 25 years of experience in facial surgery exclusively. He has performed over 2,500 rhinoplasties and is the founder of 8 West Clinic in Vancouver. All content in the Knowledge Hub is written or reviewed directly by Dr. Buonassisi.
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<h2>What Is Scarless Rhinoplasty?</h2><p>Scarless rhinoplasty is often considered a marketing term synonymous with closed rhinoplasty. This technique has been utilized by rhinoplasty surgeons for over a century. In closed rhinoplasty, all incisions are made inside the nostrils, leaving no visible scars on the outside of the nose. Dr. Thomas Buonassisi, MD, FRCSC — Specialist in Otolaryngology – Head and Neck Surgery, with a practice limited to facial plastic surgeries — explains that the choice between open and closed rhinoplasty depends on the specific needs of the patient.</p><p>While closed rhinoplasty is often referred to as scarless, it's important to note that open rhinoplasty, which involves a small incision on the columella, typically results in a scar that is barely visible. Therefore, both techniques can be considered 'scarless' in terms of visible scarring, depending on the execution.</p><h2>Closed Rhinoplasty vs. Open Rhinoplasty</h2><p>Closed rhinoplasty, or scarless rhinoplasty, involves making incisions inside the nostrils, which eliminates visible scarring. This method is suitable for patients who require minor adjustments to the nasal structure. On the other hand, open rhinoplasty involves a small incision on the columella, the tissue between the nostrils, allowing for more extensive reshaping of the nose.</p><p>Dr. Buonassisi emphasizes that the choice between open and closed rhinoplasty should be guided by the surgeon's assessment of which technique will provide the most predictable and aesthetically pleasing result. Each approach has its advantages, and the decision should be tailored to the patient's unique anatomical needs.</p><h2>Understanding Preservation Rhinoplasty</h2><p>Preservation rhinoplasty is a distinct technique that focuses on maintaining the natural structures of the nose, particularly the bridge. This method can be applied in both open and closed rhinoplasty procedures. The key difference lies in how the nasal bridge is treated, rather than the location of the incisions.</p><p>Dr. Buonassisi notes that preservation rhinoplasty is not dependent on whether the incision is visible or not. The technique is chosen based on the desired outcome for the nasal bridge and overall nasal structure, rather than the visibility of scars.</p><h2>Choosing the Right Rhinoplasty Technique</h2><p>When considering rhinoplasty, patients often wonder whether they should opt for an open or closed procedure. Dr. Buonassisi advises that while patients can express their preferences, the final decision should be made by the surgeon. This is because the surgeon can determine which technique will yield the most predictable, long-lasting, and aesthetically pleasing results.</p><p>The choice of technique is influenced by factors such as the extent of changes needed, the patient's nasal anatomy, and the surgeon's expertise. Ultimately, the goal is to achieve a natural-looking result that enhances both the function and appearance of the nose.</p>
Full Transcript
So what is scarless rhinoplasty? I think it's really a, you know, kind of a marketing term or a catchphrase for closed rhinoplasty, and that's something that's been done by most rhinoplasty surgeons for probably one hundred years. So in my practice, we do closed or scarless rhinoplasty. We do open rhinoplasty as well. It really depends on what needs to be done. That shouldn't be confused with preservation rhinoplasty, that is a technique that is specific to how the bridge of the nose is treated and it's really irrelevant if you make an incision that's visible or invisible in the columnella prior to doing that part of the procedure. So again, closed rhinoplasty, probably synonymous with scarless rhinoplasty, even though open rhinoplasty results in a scar that you can't see, so maybe you'd call that scarless rhinoplasty too, just depends how it's done. Yeah, I think you can choose whether you want an open or closed procedure, but I would let your surgeon choose that because they're gonna let you know which technique is gonna give you the most predictable, long lasting, and aesthetic result.
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