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What type of rhinoplasty should I get?

Choosing to undergo rhinoplasty, commonly known as a nose job, is a significant decision that needs to be considered carefully. One of the most pressing questions is the type of procedure: open or closed rhinoplasty? With a deluge of information available on the internet, making a choice can feel overwhelming, leading to hesitancy and confusion. 

At Berkeley Square Medical, with over 25 years of rhinoplasty expertise under our belt, we understand these concerns. This article delves deep into both procedures, aiming to demystify the decision-making process. By its end, our goal is to help you move forward confidently, with clarity about the best path to achieve your aesthetic aspirations.

The Basics of Rhinoplasty

Rhinoplasty, in its essence, is more than just a surgical alteration of the nose. It’s a transformative journey that, for many, symbolises a step towards a renewed self-image and confidence. 

With a history that dates back centuries, this surgical procedure has evolved significantly, offering tailored solutions to meet diverse aesthetic and functional needs. Today’s advanced techniques ensure minimal scarring, reduced recovery time, and outcomes that harmonise with an individual’s facial features.

A common query that most prospective patients grapple with: the distinction between open and closed rhinoplasty. Although both are subsets of the same overarching procedure, they differ mainly in the approach to incision. 

patient and surgeon consultation

In closed rhinoplasty, incisions are discreetly made inside the nostrils, leaving no external scars. On the other hand, open rhinoplasty involves an additional small incision beneath the nose, specifically on the columella – the tissue separating the nostrils. While this might result in a faint external scar, advancements in surgical techniques ensure it’s typically inconspicuous.

However, the choice between open and closed rhinoplasty is more nuanced than just the placement of incisions. Each technique lends itself better to specific modifications and corrections. And while the idea of no visible scars might seem appealing, the decision should ideally hinge on the nature of alterations required and the surgeon’s expertise.

Our extensive experience has shown us that a one-size-fits-all approach doesn’t apply to rhinoplasty. Every nose is unique, and understanding its nuances is crucial to deciding the most suitable technique. 

In the following sections, we’ll delve deeper into the specific scenarios where one technique might be favoured over the other, ensuring you’re equipped with the knowledge to make an informed decision.

Closed vs. Open Rhinoplasty

As we dive into the world of rhinoplasty, it becomes evident that the decision between a closed and open approach is not merely cosmetic but also functional. Both techniques have their merits, and understanding these can be pivotal in determining the best route for your aesthetic and structural goals.

Closed Rhinoplasty

This method shines in its discretion. With all incisions made inside the nostrils, there’s no concern about visible external scars. This approach is often recommended for those who require more straightforward adjustments, like slight reshaping or minor corrections. 

If your nose is relatively straight and boasts what many surgeons deem a ‘normal tip,’ a closed rhinoplasty might be the suggested route. Besides the obvious benefit of no visible scarring, this technique often results in less post-operative swelling, making the recovery process a tad smoother.

Open Rhinoplasty 

When the nose requires extensive modifications or intricate reconstructions, an open rhinoplasty might be the way to go. For noses that are notably crooked or necessitate significant reshaping, this approach provides the surgeon with greater visibility and access to underlying structures. 

The addition of an incision on the columella might raise concerns about a visible scar, but with modern surgical practices, this scar often heals exceptionally well. In fact, for most individuals, it becomes nearly imperceptible at conversational distances.

While these descriptions offer a general guideline, it’s imperative to note that the technique is not the sole determinant of the surgery’s outcome. The rapport between you and your surgeon plays a pivotal role. Clear communication about your aesthetic desires and a mutual understanding of the goals are paramount. Whether you opt for a closed or open procedure, being on the same page with your surgeon ensures the results align with your expectations.

At Berkeley Square Medical, we emphasise the philosophy that the desired outcome should dictate the technique, not the other way around. It’s about sculpting a nose that complements your face, aligns with your desires, and stands the test of time.

Expectations and Recovery

During a rhinoplasty, whether open or closed, precision is paramount. Once the necessary alterations are made, attention shifts to the closure of the incisions. 

In the case of closed rhinoplasty, the incisions inside the nose are meticulously sealed with dissolvable stitches, which naturally disappear as the healing process progresses. This eliminates the need for a subsequent visit to have them removed.

With open rhinoplasty, while the internal incisions also employ dissolvable stitches, the external incision on the columella requires a different approach. This incision is closed with stitches that remain in place until the wound heals sufficiently. Typically, a short follow-up visit to the surgeon is scheduled for their removal.

nose surgery options discussed with a patient

Post-surgery, the focus transitions to ensuring optimal healing and minimising discomfort. To curtail any bleeding and stabilise the newly sculpted nose, dressings known as ‘packs’ are inserted inside the nostrils. These packs not only stem bleeding but also aid in maintaining the nose’s new shape during the initial stages of recovery. While it’s a rarity, some cases might necessitate an external splint for added support. However, in most instances, strategic strapping and bandages are deemed sufficient.

Recovery from rhinoplasty is a gradual process. Initial swelling and mild discomfort are natural but manageable with prescribed pain relievers and diligent aftercare. As days turn into weeks, the swelling subsides, revealing the contours of your newly shaped nose.

Our Approach

At Berkeley Square Medical, we pride ourselves on our bespoke approach to each surgical journey, rooted in decades of expertise and a deep understanding of facial anatomy and aesthetics.

While many establishments might have a default preference for one technique over the other, our approach is more holistic and patient-centric. Though we typically lean towards closed rhinoplasty, our guiding principle remains: the nature and extent of the desired modifications dictate the technique. 

Opting for a closed method is not just a matter of habit but stems from its advantages, such as reduced visible scarring and often a swifter recovery period. However, should a patient’s needs require greater visualisation of the nasal structures or intricate adjustments, an open rhinoplasty becomes our method of choice. Our priority is achieving the envisioned outcome with utmost precision, ensuring the results are harmonious and long-lasting.

Another cornerstone of our philosophy is the belief in collaborative decision-making. We consider the consultation phase not just as an informative session but as an opportunity to build mutual understanding and trust. The rapport between a surgeon and a patient is pivotal. A patient’s aspirations, combined with the surgeon’s expertise, lead to a tailored surgical plan that aligns with the desired aesthetic goals.

We firmly believe that the surgeon’s skill and experience are far more critical than the mere choice of technique. A well-executed rhinoplasty, irrespective of it being open or closed, hinges on the surgeon’s proficiency, knowledge, and artistic flair. This is why we often advise potential patients to prioritise choosing the most skilled surgeon over fixating on the technique.

In the heart of London, Berkeley Square Medical stands as a beacon of excellence in cosmetic surgery, underlined by our commitment to individualised care, state-of-the-art procedures, and unwavering dedication to achieving the best outcomes for our patients. As you consider rhinoplasty, remember that you need to pick the best nose surgeon UK wide, not the technique.

Our Surgeons

When considering a surgical procedure as delicate and transformative as rhinoplasty, the credentials and affiliations of the chosen medical institution play a pivotal role. They serve as indicators of the institution’s commitment to professional excellence, adherence to stringent medical standards, and continuous dedication to advancement in the field.

Berkeley Square Medical is not just a premier institution for rhinoplasty in the UK; it is a testament to years of rigorous training, research, and successful patient outcomes. Our reputation is underpinned by our affiliations and recognitions within the medical community.

All our surgeons hold esteemed positions on the specialist registrar with The General Medical Council (GMC), an organisation that maintains the official register of medical practitioners within the United Kingdom. This affiliation ensures that our team adheres to the highest standards of medical practice, is up-to-date with the latest techniques, and commits to continuous professional development.

Our surgeons have the honour of being members of prestigious associations like BAAPS (The British Association of Aesthetic Plastic Surgeons) and BAPRAS (The British Association of Plastic, Reconstructive and Aesthetic Surgeons). These memberships are not merely badges of honour but signify our dedication to maintaining and uplifting the standards of cosmetic and reconstructive surgery in the UK.

On an international scale, our association with the International Society of Plastic, Reconstructive and Aesthetic Surgery (IPRAS) showcases our commitment to global advancements in the field. It enables us to stay abreast of international best practices, innovative techniques, and emerging trends in plastic and aesthetic surgery.

For more information about Rhinoplasty please visit:


Sanjay Rai

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