Reflections on the open and closed rhinoplasty

Summary The open rhinoplasty has been espoused by many of the young plastic surgeons of this generation. The Dallas School of Rhinoplasty Surgery has elegantly demonstrated its use. The open rhinoplasty is far from new, but was particularly used for more complex repairs of the nasal tip as, for example, in cleft lip and palate surgery. Whereas there is nothing intrinsically wrong with an open rhinoplasty it is apt to be slower, often requiring cartilage grafts, and has a wider exposure. Patients considering rhinoplasty commonly ask whether the surgery is open or closed. This presentation examines some of the features which the author has found useful and also demonstrated to a number of trainees to make the closed rhinoplasty more reliable and enhance the results, particularly in regard to infracture and tip refinement.