--- title: "Open Rhinoplasty vs Closed Rhinoplasty - Differences" description: "Key differences between Open Rhinoplasty and Closed Rhinoplasty." source: "The ENT Resident" author: "Dr. Mausumi Das" canonical_url: "https://www.theentresident.com/ent-notes-lectures/open-rhinoplasty-vs-closed-rhinoplasty-differences" categories: ["Rhinology", "Differences Tables in ENT"] video: "https://www.youtube.com/watch?v=29c-ibF0L3M" image: "https://media.theentresident.com/og-images/open-rhinoplasty-vs-closed-rhinoplasty-differences.jpg" --- # Open Rhinoplasty vs Closed Rhinoplasty - Differences Key differences between Open Rhinoplasty and Closed Rhinoplasty. Watch the full video lecture on YouTube: https://www.youtube.com/watch?v=29c-ibF0L3M Open and Closed rhinoplasty are two approaches to the rhinoplasty procedure, differing in their **incisions, exposure, visualization, surgical access, indications and post-operative course**. | Feature | Open Rhinoplasty | Closed Rhinoplasty | | --- | --- | --- | | **Concept** | Nose approached externally, through an incision on the columella | No external incision; all incisions confined inside the nostrils | | **Also Known As** | External rhinoplasty | Endonasal rhinoplasty | | **Incisions Used** | Bilateral marginal incisions joined by a transcolumellar incision | Intercartilaginous, transcartilaginous or infracartilaginous (marginal) incision | | **External Incision** | Present | Absent | | **Visible Scar** | Present, though small and heals well | Absent | | **Exposure** | Excellent | Limited | | **Visualization** | Direct binocular visualization | Indirect; surgeon relies on tactile feedback and experience | | **Surgical Access** | Wide access to all structures | Restricted | | **Tip Exposure** | Complete; both domes of the lower lateral cartilage seen simultaneously and side by side | Limited; lower lateral cartilages assessed individually through limited tunnels, with no simultaneous comparison | | **Tip Surgery** | Complex tip surgery possible | Only minor tip surgery | | **Access to Nasal Dorsum** | Excellent | Good, but not the best | | **Access to Septum** | Excellent | Good, but limited in comparison | | **Symmetry Assessment** | Easier and more accurate | Reduced accuracy, due to limited exposure and visualization | | **Teaching Value** | Better; residents can directly visualize the steps | Poor; students cannot see inside | | **Graft Placement** | Easier and more precise | More challenging | | **Suture Placement** | Easier | Difficult | | **Revision Cases** | Preferred | Technically demanding and very rarely done | | **Severe Deformity Correction** | Preferred | Very limited use | | **Saddle Nose Reconstruction** | Preferred | Not suitable | | **Cleft Nose Deformity** | Preferred | Not preferred | | **Major Dorsal Hump Reduction** | Excellent | Suitable only for minor dorsal hump reduction | | **Soft Tissue Trauma** | More | Less | | **Post-operative Edema** | More | Less | | **Post-operative Bruising** | More | Less | | **Operating Time** | Longer | Shorter | | **Recovery Time** | Longer | Shorter | | **Devascularization** | Greater disruption of subdermal vessels, especially over the tip, with a higher risk of vascular compromise | Vascular supply better preserved | | **Columellar Support** | Transiently weakened by the transcolumellar incision | Columellar region left undisturbed | | **Post-operative Numbness** | More common | Less common | | **Learning Curve** | Easier to learn, as everything is directly visualized | Steeper learning curve | > What is [Intercartilaginous incision used in Rhinoplasty](https://www.theentresident.com/ent-notes-lectures/rhinoplasty-incisions-transcolumellar-marginal-intercartilaginous-incision.md)? What are its advantages and disadvantages? > What is Transcartilaginous incision used in Rhinoplasty? What are its advantages and disadvantages? > What is Marginal incision used in Rhinoplasty? What are its advantages and disadvantages? > What are the indications of [Open Rhinoplasty](https://www.theentresident.com/ent-notes-lectures/open-external-rhinoplasty-procedure-steps-indications-advantages.md) & [Closed Rhinoplasty](https://www.theentresident.com/ent-notes-lectures/endonasal-closed-rhinoplasty-procedure-steps-indications-advantages.md)? > What are the [complications of rhinoplasty](https://www.theentresident.com/ent-notes-lectures/rhinoplasty-complications-postoperative-care.md)? --- ### Viva Pearls * **Open rhinoplasty = External rhinoplasty** * **Closed rhinoplasty = Endonasal rhinoplasty** * Open rhinoplasty uses a **transcolumellar incision with bilateral marginal incisions** * Visible external scar is seen only in **open rhinoplasty** * Open rhinoplasty gives **direct binocular visualization**; closed rhinoplasty relies on tactile feedback * Both domes of the lower lateral cartilage are seen simultaneously only in **open rhinoplasty** * Post-operative edema, bruising, operating time and recovery time are all **greater in open rhinoplasty** * Columellar support is transiently weakened only in **open rhinoplasty** --- ## About This Note This free ENT note on Open Rhinoplasty vs Closed Rhinoplasty - Differences was written by Dr. Mausumi Das and is paired with a corresponding video lecture. Canonical page of this note: https://www.theentresident.com/ent-notes-lectures/open-rhinoplasty-vs-closed-rhinoplasty-differences When citing or referencing this content, please credit The ENT Resident and link to the canonical page above. ## Related Notes by Category - Rhinology: https://www.theentresident.com/ent-notes-lectures/category/rhinology.md - Differences Tables in ENT: https://www.theentresident.com/ent-notes-lectures/category/differences-tables-in-ent.md ## About The ENT Resident The ENT Resident is an educational website and resource library created by Dr. Mausumi Das (MS ENT) for ENT residents, ENT postgraduates preparing for exams, and MBBS students. Dr. Mausumi Das writes the notes, draws the diagrams, and records the lectures herself. Browse all ENT notes and lectures on The ENT Resident: https://www.theentresident.com/ent-notes-lectures.md ## Medical-use Boundary The ENT Resident provides educational material for medical learning and revision. It does not provide patient-specific medical advice, diagnosis, or emergency care, and it is not a substitute for evaluation by a qualified healthcare professional. ## More Resources - Learn about the Premium ENT Notes, preview a complete sample, and find purchase options: https://www.theentresident.com/premium.md - Premium note for this topic, Open Rhinoplasty vs Closed Rhinoplasty - Differences: https://theentresident.gumroad.com/l/dnvaf - Read student testimonials: https://www.theentresident.com/testimonials.md - Contact The ENT Resident: https://www.theentresident.com/contact.md --- A complete index of all pages on this site, with descriptions and markdown links can be found here: https://www.theentresident.com/llms.txt