Types of Rhinoplasty

Submitted by Dr. Harmych

Types of Rhinoplasty – Explained by Dr. Harmych, MD, FACS

There are many types of rhinoplasty procedures, however, there are only two main types. The two main types of rhinoplasty include:

• Open Rhinoplasty (Open Structure Rhinoplasty)
• Closed Rhinoplasty (Closed Rhinoplasty)

Let’s discuss each of these types of rhinoplasty in more detail.

Open Rhinoplasty

Open Rhinoplasty, or open structure rhinoplasty, is a rhinoplasty procedure in which the entire skin and soft tissue envelope of the nose is dissected from the bone and cartilage of the nose. Open rhinoplasty offers more visibility of the structure of the nose and is used for more complicated cosmetic rhinoplasty procedures or functional rhinoplasty (septorhinoplasty).

The incision is divided into two connecting parts; a trans-columellar incision that crosses the bridge of skin in between the nostrils (columella) and a marginal incision that extends around the inside of both nostrils. The marginal incision in rhinoplasty is usually not visible.

The columellar incision crosses the columella and is, therefore, on the external part of the nose. However, the columellar incision in rhinoplasty is usually not visible. Most rhinoplasty procedures are performed using open rhinoplasty techniques. The majority of revision rhinoplasty is also performed with open technique.

Open Rhinoplasty Incision

Below is a before and after rhinoplasty photo from one of Dr. Harmych’s rhinoplasty patients. The rhinoplasty procedure  shown below was complex and performed for both functional (nasal breathing issues) and cosmetic (nasal appearance) indications. More complex cases are often performed using open rhinoplasty technique. On the right, we can see a well-healed rhinoplasty incision crossing the columella. This photo is taken one year after the primary rhinoplasty procedure. The columella incision is well-healed and barely visible.

The patient shown above had significant nasal breathing problems as a result of both internal and external nasal deformities. She underwent rhinoplasty to improve both the structure and function of the nose. The photo on the right, of “after” photo, shows a visible improvement in the nasal airways and substantial improvement in nasal symmetry, nostril symmetry and nasal tip definition.

Closed Rhinoplasty

A closed rhinoplasty takes advantage of incisions hidden within the nose. Minimizing the amount of dissection in rhinoplasty speeds up the healing process. Closed rhinoplasty is often used for less complicated rhinoplasty cases.

Often, closed rhinoplasty is the approach chosen for cases that are primarily cosmetic and not requiring additional functional rhinoplasty techniques, such as spreader grafting for nasal valve collapse, septoplasty and nasal tip reconstruction. Primary rhinoplasty procedures are performed closed more often than revision rhinoplasty procedures. However, Dr. Harmych will occasionally perform a revision rhinoplasty using closed technique in the correct patient.

Closed Rhinoplasty Incision

The patient shown below underwent a rhinoplasty using a closed rhinoplasty technique. There is no incision, or scar, on the columella. The marginal incisions are hidden inside the nostrils.

The patient shown above underwent a closed rhinoplasty by Dr. Harmych. There is no columellar incision. The rhinoplasty incisions here are all hidden within the nose. Significant improvement is seen in nasal tip definition and nasal symmetry.

Cost of Open Rhinoplasty and Closed Rhinoplasty

In Cleveland, Ohio patients should expect the total cost of rhinoplasty to range from $7,000 to $15,000 (including anesthesia, facility and any other fees). Keep in mind this is a range of a possible total cost. RealSelf lists the average cost for “rhinoplasty” for Ohio as $9,265. A patient might be wary of any surgical fee quotation that is higher or lower than this range. In some cases, such as revision rhinoplasty, the cost should be expected to be higher, or even much higher, than this quoted range.

The cost of both open and closed rhinoplasty is similar and depends on the following:

• Surgeon’s experience and case volume
• The degree of surgical difficulty
• History of prior rhinoplasty, septoplasty or septorhinoplasty
• History of prior trauma, or injury, to the nose
• Rhinoplasty surgery complexity
• Additional procedures such as laser skin resurfacing or blepharoplasty (or eyelid lift)

Rhinoplasty Patient Testimonial