Open Vs Closed Rhinoplasty Surgery

open-or-closed-rhinoplasty-which-is-better, best practice rhinoplasty surgery techniques

Rhinoplasty Techniques: Open Vs Closed Rhinoplasty Surgery

During a recent Interview with a Specialist Plastic Surgeon renowned for his expertise in Nose Reshaping procedures, Dr Sackelariou described the differences between Open vs Closed Rhinoplasty Surgery techniques and which patients might be suitable for these nose reshaping surgery options.

 Dr Richard Sackelariou Specialist Plastic Surgeon

Find out what nose surgery expert Dr Richard Sackelariou says about the different types of Rhinoplasty surgeries: the Open vs Closed Rhinoplasty Surgery technique.

Specialist Plastic Surgeon Richard Sackelariou was recently interviewed by Maven on our blog team. Here are the most common questions and answers about OPEN vs CLOSED RHINOPLASTY surgery techniques.


Download Our Guide to Rhinoplasty



From Maven’s INTERVIEW with Melbourne’s Expert Rhinoplasty Surgeon, Dr Richard Sackelariou.

Question 1:   What’s the best Rhinoplasty Surgery technique: Open vs Closed Rhinoplasty?

Dr Sackelariou:

The answer to the question ‘which is a better technique, open rhinoplasty or closed rhinoplasty?’ is that neither is best in every situation.

  • It really depends on a number of factors.
  • For nose reshaping surgeries that I perform, about half are open and half are closed.


Question 2: What are the benefits of a closed rhinoplasty?

Dr Sackelariou:

A closed rhinoplasty means all of the incisions are on the inside of the nostrils. The skin under the nose tip is left as it normally is.

They key benefits of the closed rhinoplasty technique, when it suits a patient’s nose reshaping needs, are:

  • Incisions are made on the inside
  • Recovery is generally quicker
  • There tends to be less swelling in the nose tip
  • Swelling that does occur tends to resolve more quickly


Question 3: What are the benefits of an open rhinoplasty?

Dr Sackelariou:

  • An “open rhinoplasty” allows me to get more direct surgical access to all of the internal aspects, and structural aspects, of the nose I’m reshaping, especially of the tip.
  • The open rhinoplasty is extremely helpful for performing more complex nose surgery procedures and for noses that require more significant reconstruction or breathing corrections.
  • For example, people who are wanting to reduce very large or boxy tips or correct previous surgeries or traumas to the face and nasal structures are typically going to require an OPEN rhinoplasty approach.


The incision areas involved in open Rhinoplasty Surgery are shown in the illustration, rhinoplasty surgery vector.


Question 4: What criteria do you use to decide between an open rhinoplasty vs a closed rhinoplasty?

Dr Sackelariou:

Closed Rhinoplasty:

If a patient’s nose reshaping goals don’t require significant adjustments, and if it’s a PRIMARY rhinoplasty surgery rather than a Revision Surgery for an earlier nose surgery – then I will choose to perform a closed rhinoplasty when possible.

Open Rhinoplasty:

All revision surgeries of earlier nose job procedures are performed as an Open Rhinoplasty. You need to fully see what the previous surgery did or didn’t accomplish and if there are any hidden surprises about the remaining structures.

  • If a patient has several issues needing to be corrected or adjusted, or if they’ve already had a prior nose surgery or nose trauma, then I will perform an open rhinoplasty.
  • That’s because if there is early damage or trauma to the nose area, it can impact the internal tissues and the septum; damage which may not be visible until you get inside to do the procedure.
  • If you’ve had head or nose trauma, it’s also typically appropriate to DO a CAT scan before proceeding with nose reconstruction surgery.
  • Also, if there’s a big nose hump needing significant reduction, or nose bridge narrowing to be done, this will tend to require an Open Rhinoplasty approach.
  • The same is true with very twisted noses (crooked noses) or hanging tips that a patient wants to reduce.


Crooked noses also benefit from the Open Rhinoplasty approach.

Often, a septoplasty is necessary to ensure the breathing is normal as possible and the nose is as straight as possible. This too requires the open surgical technique.

Basically, any repair needed to the Septum (a Septoplasty) to correct breathing issues or mild sleep apnea, will require an Open approach for most patients.


Question 5: Tell me about healing and recovery after Rhinoplasty surgery. What can be done about the bruising after having nose surgery – do you get ‘black eyes’ – or can that be reduced or mimimised?

  • The ‘black eye’ effect and other bruising related to having nose surgery can be drastically reduced if patients follow my POST-SURGERY PROTOCOLS.
  • This reduces swelling and minimises bruising to allow for a better, quicker recovery. The eyes won’t tend to swell as much; whereas patients who don’t follow this protocol may get very swollen eyes, sometimes to the point they can’t even open them.
  • One of my protocols to help reduce bruising involves the ALL-NIGHT LONG ICING METHOD – which means patients will use cool, light weight compresses over their eyes, every 10 to 20 minutes, for 18 to 24 hours after waking up from Surgery.
  • They won’t get much sleep; but once this Protocol is completed, they can rest – and they can sleep a lot (I also give them instructions for resting in an elevated position).
  • Consistency is needed for best post-surgery bruising prevention effects.

I’ve seen my special icing protocols get patients ZERO bruising and no discolouration around the eyes.

The Protocol is:

  • I give very clear instructions to nose surgery patient about which types of thick cloths or thick gauze, dipped in freezing cold ice water, are best for this method.
  • Cool cloths are then used over the eye and upper nasal bridge area (above the bridge, not on the bridge).
  • New cool cloths are applied and reapplied gently and softly, all through the night, but NOT on the place that’s been operated on.


Question 6: What is Rhinoplasty Recovery like?

Rhinoplasty recovery can vary from patient to patient, although general recovery guidelines often include:

  • Sleeping in an elevated position (2 pillows) for 6 days.
  • Most post-surgery swelling resolves by Week 6 to Week 8.
  • The nose or nasal breathing may be “blocked” for a week or longer, from swelling on the inside; so expect to breathe through your mouth.
  • You’ll see the general results after nose surgery in approximately 4 to 12 weeks’ time, with ‘final results’ visible between 6 and 12 months.


Download Our Guide to Rhinoplasty


Ready to explore YOUR surgery options for Rhinoplasty procedures with Dr Sackelariou, one of Melbourne’s sought after Specialist Plastic Surgeons for nose reshaping?

Specialist Plastic Surgeon, Dr Sackelariou, is one of Australian’s premier nose reshaping surgeons. He is the go to Surgeon for his expertise in open and closed Rhinoplasty techniques and his minimal bruising/rapid healing protocol advice. So his Melbourne consultation schedule fills up quickly.

To schedule a consultation with Dr Sackelariou, our highly respected Plastic Surgeon for advanced Rhinoplasty procedures and cosmetic nose reshaping surgery, please phone us on (03) 8849 1444 today.


Visit our Downloadable Guides page for more information about Cosmetic and Plastic Surgery options and research in Australia.

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Aesthetic Plastic Surgery

Volume 23, Issue 3pp 170–174Cite as

Psychosocial Impact of Cosmetic Rhinoplasty

Last accessed online on 18 November 2018.


Dr Richard Sackelariou - MBBS, FRACS, FRCS
Dr Richard Sackelariou, MBBS, FRACS/FRCS, is a leading Sydney Specialist Plastic, Cosmetic & Reconstructive Surgeon who sees patients in two locations: Double Bay, Sydney and Melbourne VIC (Australia). Dr Sackelariou offers extensive experience in attaining natural-looking, excellent surgical results for patients of all ages. Graduate of Sydney University, FRACS, Plastic and Reconstructive Surgery plus additional training in Cosmetic Surgery in Paris at the Clinique Turin in 1994.BIO PAGE: Click here