Procedure Guide · June 2, 2026 · 6 min · By Emory Blackwood
Open vs. closed rhinoplasty: what the difference means for you
Two surgical approaches, one tiny external scar, and how surgeons choose.
Rhinoplasty is performed by one of two access routes, and patients often fixate on the choice more than they need to, though understanding it helps.
In closed rhinoplasty, all incisions are inside the nostrils, leaving no external scar. The surgeon works through limited access, which suits more straightforward changes. In open rhinoplasty, a tiny additional incision across the columella (the strip of skin between the nostrils) lets the surgeon lift the skin and see the nasal framework directly, offering more control for complex reshaping, revisions, and significant tip work. The columellar scar typically heals to near-invisibility.
There is no universally superior technique; the right one depends on what your nose needs and your surgeon's training and preference. Complex tips and revisions often favor open access for precision; modest refinements may be done closed. A good surgeon explains why they recommend one for your specific anatomy rather than applying a single approach to everyone. The external-scar question, which worries many patients, is rarely the deciding factor in the result.
Related reading: Facial Plastic Surgeon vs Plastic Surgeon: What the Difference Means for Rhinoplasty.