Dr. Serhan Derin, born in 1982, is a seasoned ENT specialist who graduated from Ankara University School of Medicine. He completed his residency at Kocaeli University in 2010. Dr. Derin is a highly skilled surgeon specializing in functional and cosmetic nose surgeries, including Primary Rhinoplasty, Revision Rhinoplasty, Ethnic Rhinoplasty, Septoplasty, Septorhinoplasty, Nasal Valve Surgery, and Sinus Surgery.
This is the second step of your 8 part journey into the exclusive guide on rhinoplasty types.
Scarless nose surgery is not a dream, closed rhinoplasty can give you that, but how? With delicate techniques and challenging methods, surgeons operate a closed rhinoplasty to achieve the most desirable outcomes for your nose. What is the secret behind this method? How do they achieve an aesthetically pleasing yet natural-looking nose? Who is a good candidate for the surgery?
In this article, we will explain closed rhinoplasty in-depth, starting with the first question.
What is a closed rhinoplasty?
Closed or endonasal rhinoplasty gives you the desired nose shape with no visible scars by making minor corrections. To achieve these, surgeons make all the incisions within your nostrils and operate through narrow openings. That is why this technique is also called a scarless nose job or closed atraumatic rhinoplasty. You will have a shorter recovery period and less swelling thanks to its unique way of operating on your nose.
This is a rather hard and challenging approach to give you balanced nasal features with the rest of your face. A skilled surgeon who has years of experience in the field is a must to operate your closed rhinoplasty surgery.
What can closed rhinoplasty change?
Closed rhinoplasty can change the tip of the nose, nostrils, and bridge shape while addressing any functional problem if necessary. You might wonder, while the things you can achieve are pretty much similar to traditional rhinoplasty operations, why do doctors prefer closed rhinoplasty then? To make your nose appear better with less invasiveness. Surgeons can perform all the things mentioned below with a closed rhinoplasty.
- Define the tip of the nose
- Reduce a hump, or the nostrils
- Correct a deviated septum
- Modify the projection of the nose
However, in more complex cases a conventional method may be a more suitable option than a closed technique.
Who is a good candidate for a closed rhinoplasty?
If you are seeking hump reduction, small tip alterations, or to reduce the width of your nose without no one noticing you had nose surgery, closed rhinoplasty might be a good option to fulfill your desires. The surgery will make all the incisions inside your nostrils, and protect the shape of your nose, and the results will resemble as if you were born with that nose.
In addition, you should know that the surgery is not a miracle and people with realistic expectations are more likely to be satisfied with the outcomes.
Generally, it is recommended to be over 16 years old and has no chronic diseases like heart disease or diabetes for a healthy surgery procedure. Speaking of health, how do we know if the procedure is safe?
Is closed rhinoplasty safe?
Yes, a closed surgery in the hands of an experienced surgeon is highly safe. In a study including 234 rhinoplasty cases, there were only 2 patients with complications and they were treated with medications (2). Yet, it includes some risks for people who had previous rhinoplasty surgeries and want to make drastic changes over their noses. It is best to consult your surgeon about which approach is better for your rhinoplasty operation.
What are the limitations?
It is always good to keep in mind that closed rhinoplasty also comes with some limitations. Most of the time in revision surgeries, instead of a closed approach doctors might prefer the traditional way. Besides, if you have severe breathing problems or/and want to alter the shape of your nose, surgeons might also recommend you a safer option than closed rhinoplasty. The reason behind these preferences is the poor visual control over your nose in a closed approach.
Long story short, a closed rhinoplasty can give you the nose shape you want and correct deformities without any visible scars on the outside. Although, in some serious cases, surgeons might prefer a safer option of an open approach.
If you’d like more information on whether you’d like to get an open or closed procedure, you can check our article where we compare the two approaches side by side.
Can you get a revision rhinoplasty with a closed approach?
Yes, it is possible to correct some minor unwanted results of your first or previous surgeries with a closed approach. Although, in some difficult cases which call for drastic changes without endangering nose structure, a regular open approach would be better.
For now, we have looked through what you can achieve with closed rhinoplasty. Now we will mention which changes surgeons make on your nose to enhance your beauty. How does a closed rhinoplasty work?
What happens in a closed rhinoplasty?
As to give you the best results from the surgery, surgeons ask you to start preparing the way before the surgery day. When the surgery day comes and you lay down in the operating room, they start operating on you by first giving anesthesia. And then they cut through each of your nostrils and make changes inside. Through each narrow opening, skilled surgeons add cartilage, suture some tissues, and shape your nose in the intended way.
1. Journey begins with preparation
First, you will be given certain instructions before the surgery. You will be asked to stop smoking for 2 weeks before the surgery, the better you leave it earlier as it can prolong the healing process. If you are on medications your doctor would like to know and might ask you to stop using some of them, especially blood thinners.
2. During the day of the surgery
During the day of the surgery, you might have been instructed to stop eating after midnight before the surgery day. That way it will reduce the complications of anesthesia. Local or general anesthesia is preferred during the surgery which means pain-free operation.
3. The beginning incisions
Surgeons start making incisions in each of your nostrils after anesthesia showed its effects. These internal incisions will give entrance to your surgeon to operate without making any visible scarring on the outside.
4. Delicate techniques
After that, surgeons alter the shape of your nose with the help of specialized tools like osteotome to reduce your hump and measure every detail with a caliper to make it symmetrical on each side. By using regular or tailored cartilage grafts and suture techniques, they enhance your beauty (3).
5. The duration of the operation
Usually closed rhinoplasty operation takes 1-2 hours, though in certain conditions it can go up to 3 hours. Thanks to its easier preparation process and the extensive experience of the surgeon it has a shorter surgery time.
6. What makes it challenging
With closed rhinoplasty, it is much more challenging to operate in your nose through narrow openings. That is why for better-closed rhinoplasty results, a skilled surgeon with years of experience in the field is necessary.
Afterward a closed nose operation: expectations, recovery, and results
Up to now, we learned, what is closed rhinoplasty surgery, what can you achieve with it, and the surgical procedures. Now, it is time to talk about what eawaits you afterward. Here, we will go through every detail from the moment you wake up from the surgery until the last residual swelling is gone.
What to expect after the operation
After you woke up from your closed rhinoplasty operation, you will have nasal taping and cast around your nose to protect its shape. You might feel a little dizzy and nauseous, which is also possible due to anesthesia, but these will subside after a day.
During your first days, you might have some mild or moderate pain. Your surgeon will prescribe you medications to ease the pain. You will be given some strict instructions to follow during your recovery period.
Does closed rhinoplasty leave scars?
No, closed or atraumatic rhinoplasty does not leave noticeable scarring. Surgical procedures in this method aim to give you a scarless recovery process.
Recovery after a closed rhinoplasty
After your closed-nose job, you need to rest for a week or two to guarantee a complication-free recovery procedure. Moderate swelling is common during this time, and it will all subside after the first 2-3 weeks. Thanks to its less invasive techniques you will have much more blood circulation around your nose, meaning less swelling. For the best results from the surgery during your healing time:
- Avoid eating hot and harsh foods for the first days
- Keep your head elevated until the swelling is mostly gone
- Stay away from strenuous activities for 4-6 weeks
- Protect your nose from any external damage
- Pick comfortable clothes, wearing a shirt is a good idea
- Stay away from sunlight; wear a hat or sunscreen
Following your surgeon’s instructions is crucial to have a smooth recovery process.
Full recovery time of a closed nose job
The desired results can be seen after the first week when your tapes are removed. Although for sharp eyes, some swelling can be seen and patients will also feel it for up to 6 months. Residual swelling that is barely noticeable lasts for a year. And now you have the final results of the surgery.
What are the closed rhinoplasty cost and fees I need to know about?
The price of closed rhinoplasty greatly depends on many factors, and you might see different numbers even in the same city. The average cost for the surgery is around 8,000$, while it can be as cheap as 2,500$ and might be costly as 20,000$.
The location, expertise of your surgeon, the complexity of your surgery, and your demands make the numbers change. You should know that the cost is not always a sign of quality, but it is good to check on numbers around the same location to get a trustable average price and to avoid botched surgeries.
Since you might be wondering and checking the prices on the internet, it is our advice for you to make sure the price you see includes everything in it. That is to say, some clinics charge you separately for the surgeon’s fee and the operation’s fee.
Our last piece of advice to you is to look for prices in different countries as well. It might surprise you but the prices in developing countries might be cheaper, and that is why people who live in highly developed countries look for medical tourism options. You can also save some money with insurance companies, and banking loans or payment plans should help you with the payment.
Hopefully, after successful rhinoplasty surgery, you will achieve your dream nose with your surgery. Make sure to follow our highly comprehensive articles to learn every piece of information and do not hesitate to contact us!
References:
(1) Scattolin A, D’Ascanio L. Grafts in “closed” rhinoplasty. Acta Otorhinolaryngol Ital. 2013;33(3):169-176 Link
(2) Azzawi SA, Kidd T, Shoaib T. Closed Rhinoplasty: A Single Surgeon Experience of 238 Cases over 2 Years. Indian J Otolaryngol Head Neck Surg. 2022;74(3):255-259. doi:10.1007/s12070-020-01990-y Link
(3) Gökçe Kütük S, Arıkan OK. Evaluation of the effects of open and closed rhinoplasty on the psychosocial stress level and quality of life of rhinoplasty patients. J Plast Reconstr Aesthet Surg. 2019;72(8):1347-1354. doi:10.1016/j.bjps.2019.03.020 Link
