When considering having a rhinoplasty, there's a lot of discussion involving whether or not the rhinoplasty should be performed open, which means making a small incision in the skin right here or closed which means making no incisions in the skin and only making incisions on the inside of the nostrils. Different surgeons have different opinions on whether or not rhinoplasty should be performed open or closed. In my opinion, the majority of the rhinoplasty's that I do I perform open. In my hands, I feel that I am better able to visualize the anatomy of the nose. I am better able to visualize whatever the anatomic problem is with the patient's nose. And, since I'm able to see everything so clearly, I'm better able to make whatever correction needs to be made and put everything back together precisely the way in which I want it. A closed rhinoplasty does have its benefits.
There is no scar on the skin. There's no incision on the skin. There's less swelling after the surgery. But, in my opinion, the visualization of the surgical field is much less. So, the surgeon is not able to be as precise in his corrections as if the incision was made then if the incision was performed in the open fashion. When an incision is made in the lower part of the nose in the skin in this area, it tends to heal beautifully and the scar tends to be barely noticeable. It's fairly well known that swelling in open rhinoplasty lasts longer than swelling in closed rhinoplasty. However, that usually resolves within a few months, possibly six months. Most people will say that, worst case scenario, swelling will last for about a year. The ultimate the result I believe is better if the rhinoplasty is performed open.