Rhinoplasty, or nose surgery, is one of the most popular cosmetic procedures performed today. It can be done to enhance the appearance of the nose, improve nasal function (such as breathing), or correct congenital defects or injuries. Among the various techniques used in rhinoplasty, closed rhinoplasty is a minimally invasive option that has several advantages for the right candidate. In this article, we’ll dive into what closed rhinoplasty is, the procedure itself, its benefits, and what to expect in terms of recovery and results.
What is Closed Rhinoplasty?
Closed rhinoplasty is a technique where the surgeon makes all incisions inside the nostrils (as opposed to open rhinoplasty, where there is a small incision across the columella—the skin between the nostrils). Because there are no external incisions, closed rhinoplasty is sometimes referred to as “scarless” rhinoplasty. This method allows the surgeon to access the nasal structure, including the cartilage and bones, and reshape them to achieve the desired result, all while keeping the incisions hidden from view.
Key Features of Closed Rhinoplasty
Incision Location: All incisions are made inside the nostrils, which means there is no visible scarring on the outside of the nose. This is one of the most significant advantages of closed rhinoplasty.
Minimal Disruption: Since the incisions are hidden inside the nostrils, there is less swelling and bruising compared to open rhinoplasty, where the external incision may cause more tissue disruption.
Limited Exposure: While closed rhinoplasty is an effective option for many patients, it’s important to note that the surgeon has less visibility and access to the nasal structures. This makes it most suitable for less complex procedures, where only minor adjustments to the nose are required.
Nasal Tip Refinement: Closed rhinoplasty is particularly well-suited for modifying the dorsal hump (the bridge of the nose) and refining the nasal tip, though some complex tip reshaping may be more challenging with this technique.
The Closed Rhinoplasty Procedure
1. Consultation and Planning
Before any surgery, you’ll undergo a detailed consultation with a board-certified plastic surgeon who specializes in rhinoplasty. The surgeon will evaluate your nasal structure, facial features, and aesthetic goals. They will also determine whether closed rhinoplasty is the best approach for your case. The surgeon may take 3D images of your nose to help plan the procedure and discuss the expected outcome.
During this consultation, the surgeon will explain the process, risks, benefits, and recovery expectations. This is an important time to discuss your desired results and ensure that you have realistic expectations about the outcome.
2. Anesthesia
Closed rhinoplasty is typically performed under general anesthesia or local anesthesia with sedation, depending on the complexity of the surgery and the patient’s preference. General anesthesia is more common for most rhinoplasty procedures to ensure that the patient is fully relaxed and comfortable throughout the surgery.
3. Making Incisions and Reshaping the Nose
Once the anesthesia takes effect, the surgeon will make small incisions inside the nostrils to access the nasal structures. Through these incisions, the surgeon will reshape the underlying cartilage and bone to achieve the desired appearance. This can involve removing a dorsal hump, narrowing the nasal bridge, or refining the nasal tip. In some cases, the surgeon may also make small adjustments to the septum if there are breathing issues.
Because the incisions are internal, the surgeon uses specialized instruments to delicately manipulate the nasal structures. Since the procedure is done within the confines of the nostrils, there is typically less tissue disruption and a faster recovery time compared to open rhinoplasty.
4. Closing the Incisions
After reshaping the nose, the surgeon will carefully close the incisions inside the nostrils using dissolvable stitches. The closed incisions are often smaller than those used in open rhinoplasty, which further contributes to the reduced visibility of scars.
5. Post-Operative Care
Once the surgery is complete, the patient will be monitored as the anesthesia wears off, and a nasal splint or internal packing may be placed to support the nose during the early stages of healing. The splint is typically removed within one week, while the internal packing may be removed a few days after surgery, depending on the surgeon’s approach.
Benefits of Closed Rhinoplasty
No Visible Scarring: One of the most significant advantages of closed rhinoplasty is that there are no external scars. Since all incisions are made inside the nostrils, there is no visible mark left on the nose, making it a desirable option for individuals concerned about scarring.
Less Swelling and Bruising: Compared to open rhinoplasty, the closed technique generally results in less swelling and bruising. The incisions made inside the nostrils are smaller, and there is less disruption of the surrounding tissue. This can mean a quicker recovery time and less noticeable postoperative symptoms.
Faster Recovery: Because closed rhinoplasty is less invasive and involves fewer external manipulations, the recovery time is often shorter. Patients can expect to return to normal activities within 7-10 days, with swelling continuing to subside over several weeks. The final shape of the nose may take several months to fully materialize, but recovery is generally quicker than with open rhinoplasty.
Suitable for Minor to Moderate Changes: Closed rhinoplasty is ideal for patients seeking modest alterations to the nose, such as reducing a dorsal hump, narrowing the bridge, or refining the tip. The procedure is less suited for those who require significant changes or have complex nasal issues, such as a very deviated septum or extensive tip reshaping.
Recovery and Aftercare
The recovery process after closed rhinoplasty is generally smooth, but patients need to follow their surgeon’s post-operative instructions to ensure optimal healing:
Swelling and Bruising: Swelling is common after rhinoplasty, and while it is typically less pronounced with the closed technique, patients should expect some degree of swelling around the nose and eyes during the first week. Bruising may occur but usually resolves within a few days.
Pain Management: Discomfort after closed rhinoplasty is typically mild to moderate, and patients are usually prescribed pain relievers to manage any post-operative pain.
Nasal Splint and Packing: A nasal splint may be placed to protect the newly shaped nose during the initial healing period. If internal packing is used, it will be removed within a few days after surgery.
Follow-Up Appointments: Regular follow-up visits will be scheduled to monitor healing and address any concerns.
Final Results
The results of closed rhinoplasty become more apparent as swelling subsides, typically within a few weeks. However, full results may take up to a year as the nose continues to refine and settle into its new shape. The final result should be a well-proportioned nose that harmonizes with the patient’s facial features, with no visible scarring.
Is Closed Rhinoplasty Right for You?
Closed rhinoplasty is an excellent option for individuals seeking subtle cosmetic improvements to their nose with minimal scarring and a faster recovery. However, it may not be suitable for everyone, particularly those who need significant structural changes or who have complex nasal issues. It’s important to consult with a board-certified plastic surgeon who specializes in rhinoplasty to determine whether the closed technique is right for your specific goals and anatomy.
Ultimately, a successful closed rhinoplasty should leave you with a natural, balanced nose that enhances your overall facial appearance without the visible signs of surgery.
