Open and closed rhinoplasty (minus the “versus”): analyzing processes

Both open and closed rhinoplasties involve common processes that are impacted by the choice of approach. Careful analysis is necessary to understand how each approach affects the surgeon's assessment of intrinsic anatomy, limits or expands surgical options, and influences the degree of surgical control. According to the author, any surgeon who performs all rhinoplasties using either an open or closed technique exclusively is likely compromising optimal results in some patients. The relative advantages or disadvantages of the open and closed approaches in specific clinical situations are discussed, with emphasis on the basic principles for achieving optimal results in primary and secondary rhinoplasty.