There are two established ways to go about a rhinoplasty procedure – the open and closed methods. The main difference between each quite simply is the location in which the incision to access the nasal bones and cartilages to be modified is made. In the older, open method the incision was made on the outside of the nose, while in the newer, now more popular method called a closed rhinoplasty, the incision is made inside the nostrils. Dr Allan Kalus, from Avenue Plastic Surgery in Victoria, performs many rhinoplasty ops each year and we asked him to help us learn more about each.

Which one then is better for most cases? It depends on who you ask. Some surgeons exclusively use one method; some are capable of doing both and will choose depending on the patient/client’s needs. Each method has their pros and cons and the surgeons have their own reasons for their preference based on their training and experience.

This difference of where the incision is made dictates how the rhinoplasty procedure is done. With the external incision of the open method, the surgeon is able to lift the nose skin up to directly see the internal areas of correction and make precise modifications to it. The primary concerns with this method however is that the external incision on the columella could end up becoming an unsightly scar. Proper care with the suturing process however will allow the incision to heal well and greatly minimise visible scarring, which any good surgeon should be capable of. Other criticisms of the open method include longer healing time and swelling of the nasal tip. Some surgeons further argue that because the open method requires more flesh to be dissected, it could compromise the natural supporting structures of the nose.

Closed rhinoplasty, no visible scars

Closed rhinoplasty has the advantage of having no externally visible scars and of having a faster healing time. Since the incision is inside the nostrils, the surgeon will not directly see the areas of correction, and instead they skilfully feel for it. This method also allows them to immediately see the effects on the external appearance of the nose as they make the modifications internally.

Being able to directly see the internal structures of the nose through an open procedure will naturally allow the surgeon to make more precise and complex modifications to it. Excellent results however are similarly attainable with the closed procedure especially in the hands of a skilled cosmetic surgeon. Generally, in most cases, closed rhinoplasty is recommended while open rhinoplasty may be recommended for correcting more complex deformities. Dr Kalus says, “In my view, open rhinoplasty is best reserved for those patients with complex nasal tip or septal deformities and for surgeons who only feel confident of achieving the required changes by using an open approach.”

There is no straight answer as to which of the two methods is better. The choice ultimately boils down to the surgeon’s expertise on either methods or the client/patient’s preference.

Dr Allan Kalus performs many rhinoplasties each year and his extensive experience allows him to produce natural looking results that ensure the nose is in harmony with the rest of the face. He says, “Rhinoplasty is not only about making the nose smaller, but also involves restoring the delicate balance that exists between the nose and the other facial features. We use Computer imaging to enable precise planning and allow you to visualise your result before committing to surgery. It’s no doubt that rhinoplasty can change a person’s life. Often, we find patients have been worrying about their nose often since school days, since they were teased about their nose in school. It’s such a privilege to be able to help so many people to overcome their self consciousness and, in many ways, to realize their dreams, by making their nose just blend into their face and look normal again.”

To arrange a consult with Dr Allan Kalus you can contact his clinic on 03 9521 1777. If you’d like more information on rhinoplasty or Dr Allan Kalus check out these blogs:

Dr Kalus talks about rhinoplasty surgery – video and blog
Dr Allan Kalus and his facelift tricks
Is Rhinoplasty Your Surgeon’s Specialty?