Some patients also need functional issues corrected, such as a deviated septum or trouble breathing.

For me, a good Rhinoplasty isn’t simply about making the nose smaller. It’s about creating a nose that’s in harmony with the face and still looks natural.

In an open Rhinoplasty, in addition to the internal incisions, we make a small incision on the columella, the strip of skin between the two nostrils. This allows us to carefully lift the skin and get a more direct view of the structures we’re reshaping.

In a closed Rhinoplasty, all incisions are made inside the nose. This means there’s no visible external incision on the skin that separates the nostrils. For many patients, this type of surgery can also lead to a slightly faster recovery in terms of swelling, since the skin covering the nose isn’t fully lifted.

One technique that pairs especially well with the closed approach is called Dorsal Preservation. It’s worth remembering that Rhinoplasty is fundamentally a surgery of the nasal skeleton, meaning the nasal bones and the cartilage framework.

With Dorsal Preservation, the goal is to leave as many of the nose’s natural structures intact as possible and change as little as possible while still achieving the desired result. This often means avoiding disruption of the cartilage structures that are important for normal breathing. Even while preserving these structures, we can still reduce the cartilage portion of a dorsal hump, perform controlled osteotomies to fracture and reposition the nasal bones for a bony hump, and narrow the middle part of the nose.

This is probably the most important question. You shouldn’t choose a technique just because you’ve seen someone else’s result.

Every nose has a different structure. Even two patients who want similar changes may need completely different techniques.

During a consultation, I evaluate things like:

• The shape and structure of your nose.
• The nasal bridge.
• The tip and its projection.
• The symmetry of your nose.
• Your skin and tissues.
• The internal structure of your nose.
• Your breathing and any functional issues.
• The changes you’d like to make.
• Your expectations for the result.

With all of this information, we can determine which technique best fits your case.

Recovery can vary depending on the surgery performed and how many changes are needed. Rather than focusing only on whether the surgery is open or closed, we need to consider which procedures were performed during the operation.

After Rhinoplasty, it’s normal to have swelling and some bruising, especially during the first few days. Swelling can take several weeks to go down, and the final result can keep evolving over several months.

The tip of the nose, in particular, can take longer for the swelling to settle. During this time, it’s important to follow your surgeon’s instructions and attend your scheduled follow-up appointments.