Rhinoplasty is a surgical procedure that reshapes and restructures the nose, often to address both functional and aesthetic concerns. This procedure is often categorized into two principal approaches: closed rhinoplasty and external rhinoplasty. (1) The most effective method for each patient may vary, as the two approaches require different considerations based on the patient’s nasal anatomy, concerns, aesthetic goals, and the comfort of the surgeon performing the procedure.
For either approach, it is of utmost importance that you choose a qualified surgeon who has extensive experience in rhinoplasty. Dr. John E. Sherman is a well-known surgeon based in New York City who is dedicated to helping his patients achieve exceptional results. With 40 years of experience, he is an expert in his field and has extensive knowledge of the nuances required of both rhinoplasty approaches.
To learn more about your rhinoplasty options, please schedule a consultation with Dr. Sherman online or call our office at (212) 535-2300.
Contents
- 1 About Closed Rhinoplasty and External Rhinoplasty
- 2 Benefits
- 3 Candidates for Closed Rhinoplasty vs. External Rhinoplasty
- 4 Personal Consultation
- 5 Preparation
- 6 Procedure
- 7 Recovery
- 8 Results
- 9 Cost of Closed and External Rhinoplasty in New York City
- 10 FAQ
- 10.1 What is the main difference between a closed and external rhinoplasty?
- 10.2 How long will it take for Dr. Sherman to perform my rhinoplasty?
- 10.3 How long will my rhinoplasty recovery take?
- 10.4 Will there be any noticeable scarring after my closed or external rhinoplasty?
- 10.5 Can I combine either a closed or external rhinoplasty with another procedure?
- 10.6 How long will it take to see my final rhinoplasty results?
- 11 References
About Closed Rhinoplasty and External Rhinoplasty
The nose is composed of intricate structures, including soft tissue, cartilage, and bone. Because of this complex anatomy, surgical approaches must be carefully tailored to address both the structural and aesthetic needs of each patient. Not every patient requires the same corrections or the same depth of correction, which has led to the development of the following two primary techniques.
Closed Rhinoplasty
During a closed rhinoplasty, each of the incisions is made within the nose, leaving no external scarring. This approach has been shown to result in an overall shorter recovery time. (2) Dr. Sherman uses this technique for approximately 50% of his patients; he reserves this approach for patients requiring minor or more subtle enhancements.
Dr. Sherman’s extensive experience allows him to visualize the nasal structures during closed rhinoplasty, allowing him to accurately predict results.
External Rhinoplasty
External rhinoplasty places an incision on the columella, the strip of flesh between the nostrils. (2) Dr. Sherman reserves this technique for patients in need of more extensive adjustments, such as cartilage graft placement, dorsal hump reduction, and nasal bridge straightening, as external rhinoplasty allows for more complete visualization. If the patient needs aesthetic refinement and management to improve the functional aspects of breathing, Dr. Sherman uses the open approach.
Benefits
Both closed and external rhinoplasties offer unique benefits.
The benefits of closed rhinoplasty include:
- No External Scarring: A closed rhinoplasty places incisions on the inside of the nostrils, meaning patients do not have to worry about visible scarring post-procedure.
- Shorter Procedure Time: Closed rhinoplasty can often be performed more quickly.
- Quicker Recovery: Because there is less invasion, patients who receive a closed rhinoplasty often see less downtime.
- Maintains Structural Support: By avoiding extensive exposure of the nasal framework, closed rhinoplasty helps preserve the nose’s strength and stability, reducing the risk of long-term complications. (2)
The benefits of external rhinoplasty include:
- Greater Visibility: When performing an external rhinoplasty, Dr. Sherman can visualize and access the underlying structures of your nose more easily.
- More Precision: External rhinoplasties allow for more complex reshaping and restructuring to take place, especially during revision rhinoplasties.
- Allows Graft Placement: With this approach, Dr. Sherman can place cartilage grafts to improve the structure or projection of the nose, providing more substantial results. (2)
Candidates for Closed Rhinoplasty vs. External Rhinoplasty
Candidates for rhinoplasty include individuals seeking to improve the shape, size, or symmetry of their nose, as well as those with functional issues affecting breathing or nasal function.
Closed rhinoplasty is often more suitable for patients who require subtler or minor corrections and those who do not require significant structural work. Patients needing extensive or complex corrections, structural reconstruction, or revision surgery are typically better candidates for an external rhinoplasty.
All candidates interested in rhinoplasty should be in good general health and maintain realistic expectations for their results. Dr. Sherman will determine each patient’s eligibility during their personal consultation.
Personal Consultation
During the personal consultation, Dr. Sherman will explain the differences between closed and external rhinoplasty in depth. He will ask about your medical history, concerns, and goals, as well as evaluate your nose. He will use these details to determine your eligibility and develop your tailored treatment plan, which will use either the closed or external technique.
To schedule your consultation and receive a personalized treatment plan, please submit our online contact form or call our Manhattan office directly at (212) 535-2300.
Preparation
Dr. Sherman will provide you with a set of personalized pre-operative instructions during your personal consultation to help you prepare for your rhinoplasty. Guidelines often include:
- Refrain from taking medications and supplements with blood-thinning properties.
- Stop drinking alcohol several days before and after the procedure and completely cease nicotine use several weeks in advance.
- Arrange transportation home after the procedure, as well as time away from work and other commitments.
Procedure
Both closed and external rhinoplasty are typically performed on an outpatient basis using either deep intravenous (IV) sedation anesthesia or general anesthesia. While the exact duration of the procedure will vary depending on the details of your specific treatment plan, rhinoplasty often takes one to two hours to complete.
Recovery
Dr. Sherman will provide you with a set of tailored recovery instructions before your procedure. When recovering from rhinoplasty, you can expect to experience swelling, bruising, or tenderness in and around the nose.
If you underwent external rhinoplasty, you may experience more swelling, especially around the nasal tip. If you undergo a closed rhinoplasty, recovery may be quicker with less general swelling.
After your procedure, Dr. Sherman will have placed supportive splints to protect and maintain the shape of your nose. You will need to wear this splint consistently throughout your initial recovery; several weeks later, at a prescheduled follow-up appointment, Dr. Sherman will remove the splint for you.
Results
While you will be able to notice changes immediately, you will be able to see the new shape of your nose once swelling diminishes. It can take up to a year for the nose to fully settle.
The results of both closed and external rhinoplasty are essentially permanent, allowing you to enjoy your renewed appearance for years. It is important to keep in mind that the nasal tissues will continue to age normally over time, so results may evolve. Dr. Sherman’s techniques ensure optimal stability and long-term satisfaction for his patients.
Cost of Closed and External Rhinoplasty in New York City
The cost of your rhinoplasty will vary depending on the details of your treatment plan. During your consultation, Dr. Sherman will provide a comprehensive price quote for your procedure.
Our practice is also partnered with PatientFi to offer financing options to make treatments more accessible. If you are unsure if financing is right for you, our patient coordinators can answer any questions you may have. Those interested in additional savings are also encouraged to explore our specials.
To learn more about the costs associated with rhinoplasty, please schedule a consultation online or call (212) 535-2300.
FAQ
What is the main difference between a closed and external rhinoplasty?
A closed rhinoplasty places incisions completely within the nostrils to avoid any external scarring. An external rhinoplasty places an incision on the columella, or the skin between the nostrils. Closed rhinoplasty is best for milder corrections, but Dr. Sherman’s expertise allows him to perform this procedure on a wide range of candidates. Patients requiring graft reconstruction or a revision procedure may require an external rhinoplasty.
How long will it take for Dr. Sherman to perform my rhinoplasty?
The duration of your procedure will depend on the details of your treatment plan. Closed rhinoplasty procedures are often shorter than external rhinoplasty procedures. In any case, rhinoplasty typically takes between one and two hours to complete.
How long will my rhinoplasty recovery take?
Each patient’s recovery timeline will vary, but most patients can return to work within one to two weeks. You will, however, need to continue refraining from engaging in strenuous or high-impact activities until Dr. Sherman clears you to return.
Will there be any noticeable scarring after my closed or external rhinoplasty?
Patients who undergo closed rhinoplasty will not be left with any visible scarring, while those who undergo external rhinoplasty will experience very minor scarring between the nostrils. Dr. Sherman’s expertise ensures that scarring is as discreet and minimal as possible. Scarring typically fades until inconspicuous and barely noticeable.
Can I combine either a closed or external rhinoplasty with another procedure?
Yes, you are welcome to combine your rhinoplasty with another cosmetic procedure for further facial rejuvenation. For more information, we ask that you discuss this topic during your consultation or call our office to speak to a member of our team.
How long will it take to see my final rhinoplasty results?
Initial swelling will subside within a few weeks, allowing you to see noticeable changes fairly quickly. However, subtle swelling can persist for several months, and it may take up to a year for the final shape of your nose to be fully refined.
References
- Gupta R, John J, Ranganathan N, et al. Outcomes of Closed versus Open Rhinoplasty: A Systematic Review. Archives of Plastic Surgery. 2022;49(05):569-579. doi:https://doi.org/10.1055/s-0042-1756315
- Hohman MH, Fichman M, Piedra IT. Rhinoplasty. Nih.gov. Published September 2, 2024. https://www.ncbi.nlm.nih.gov/books/NBK558970/#article-28523.s9