Closed vs Scarless Rhinoplasty Explained

• Scarless rhinoplasty is often synonymous with closed rhinoplasty, involving internal incisions.
• Open rhinoplasty includes a small external incision but can also result in minimal visible scarring.
• Preservation rhinoplasty focuses on maintaining nasal structures and can be performed with either incision type.
• The choice between open and closed rhinoplasty should be guided by the surgeon's expertise for optimal results.
• Both techniques aim to achieve a natural appearance and improved nasal function.

What Is Scarless Rhinoplasty?

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.

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.

Closed Rhinoplasty vs. Open Rhinoplasty

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.

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.

Understanding Preservation Rhinoplasty

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.

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.

Choosing the Right Rhinoplasty Technique

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.

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.