Rhinoplasty approaches fall into one of two categories: open and closed. Each approach has distinct benefits. However, we recognize that misinformation has widely spread, deeming one technique “better” than the other.
At Pearlman Aesthetic Surgery, we empower beauty™—not only through proven surgical skill, but also by empowering you to make informed decisions. When you work with a highly skilled surgeon, you can achieve incredible results through an open or closed rhinoplasty in NYC. Neither approach is universally more effective than the other, and the recovery process is identical.
As an award-winning, highly published, and dual board-certified facial plastic surgeon who has performed thousands of successful rhinoplasty procedures, Dr. Steven Pearlman leads the leaders. Continue reading to discover the truth about how open and closed rhinoplasties compare, and how to determine which may be best for you.
Understanding Rhinoplasty Surgery
Rhinoplasty is one of the most popular cosmetic surgeries, focused on reshaping the nose to improve its appearance. However, it can also involve functional enhancement, addressing structural abnormalities that inhibit breathing or smelling, such as nasal polyps or a deviated septum.
At Pearlman Aesthetic Surgery, we specialize in a wide range of nose procedures, including:
- Rhinoplasty
- Revision Rhinoplasty
- Piezo Ultrasonic Rhinoplasty
- Ethnic Rhinoplasty
- Preservation Rhinoplasty
- Teenage Rhinoplasty
- Septoplasty
Investing in a rhinoplasty or “nose job” is a personal decision, as it’s an investment in yourself. However, the surgeon you trust to perform your rhinoplasty, as well as the techniques they use, determines your results. Dr. Pearlman performs both open and closed rhinoplasty in NYC, tailoring his technique to your unique anatomy and aesthetic vision.
Closed Rhinoplasty
Closed rhinoplasty, also referred to as endonasal rhinoplasty, conceals all necessary incisions within the nostrils. Dr. Pearlman performs the procedure through separate surgical openings in the left and right nostrils, making no external incisions.
Many surgeons market this technique as a “scarless” rhinoplasty that requires less downtime than open rhinoplasty. However, a skilled surgeon can achieve the same incredible results with undetectable scarring through an open rhinoplasty, and the recovery process is identical.
Ideal Candidates for a Closed Rhinoplasty
Dr. Pearlman may recommend closed rhinoplasty in NYC if your aesthetic goals and anatomy require straightforward modifications to the bridge, septum, or nostrils. You may be an ideal candidate if you would like to refine a nasal hump, narrow the bridge, or make other subtle structural changes to the tip of the nose.
However, we must study your nasal anatomy to determine whether this technique is best for you.
Open Rhinoplasty
Open rhinoplasty, also known as external rhinoplasty, consists of making a small incision on the columella, the soft tissue that separates the nostrils. This technique creates visible access to the underlying bone and cartilage structure.
This allows for improved accuracy in reshaping the nasal framework in more complex cases, such as correcting a crooked nose through intricate suturing and/or grafting or completing a revision rhinoplasty. Completely opening the surface of the nose affords your surgeon more straightforward access to the area, allowing them to identify underlying abnormalities and better alter your nose. The extra 3 to 4-millimeter incision across the columella heals to where it is barely visible, if at all, and someone has to be closely looking up your nose to detect scarring.
Up to the mid-80s, surgeons relied solely on closed rhinoplasty techniques, and most surgeries were successful. However, complex cases require a deeper anatomical understanding—highlighting the benefit of open rhinoplasty.
Now, many inexperienced surgeons rely on open rhinoplasty in hopes that seeing patients’ nasal anatomy will yield better results, but it does not. A simple excision does not make a surgeon more skilled—knowing when to apply which technique does.
Ideal Candidates for an Open Rhinoplasty
If you are seeking a complex revision rhinoplasty, to correct significant asymmetry, or to focus on reshaping the tip of the nose, Dr. Pearlman may recommend open rhinoplasty. This technique grants him full visibility, enabling more advanced techniques such as suturing and grafting. If you’re considering a Piezo ultrasonic rhinoplasty, keep in mind that this advanced technique also requires an open approach.
In the skilled hands of Dr. Pearlman, you can achieve the same “scarless” results from an open rhinoplasty as you can through a closed rhinoplasty in NYC. In fact, open rhinoplasty provides the safest, most reliable path to achieving ideal outcomes in cases of challenging anatomy or previous surgery.
Choosing Between Open and Closed Rhinoplasty
In NYC, we empower patients to make confident decisions about their care. While the debate between open and closed rhinoplasty has gathered plenty of media buzz, the right choice for you depends entirely on your unique anatomy and goals.
While we’ve created this blog to clear up misconceptions, you cannot find the “answer” on the internet. Only an expert who understands the nuances of nasal anatomy can determine which approach is safest and most effective for you.
Choosing between an open and closed rhinoplasty truly comes down to choosing the right surgeon.
Choosing a Trusted Rhinoplasty Surgeon
We recognize that thousands of surgeons offer rhinoplasty, but they aren’t all equal. Many don’t hold board certifications, and even fewer hold double board certifications. Their expertise not only determines your results and long-term satisfaction, but also your safety.
Your nose is the centerpiece of your face, framing all of your features, and even minor alterations can make a significant impact on your overall appearance. Nasal anatomy is complex and unique to every individual, so it’s crucial to work with a surgeon with a proven track record.
Before scheduling a consultation, browse your potential surgeon’s results gallery to determine whether their results align with your aesthetic vision. Also, read through their reviews, looking beyond the star rating to identify their commitment to care beyond the operating room. Above all, your surgeon should make you feel seen, heard, and truly cared for.
Meet Dr. Steven Pearlman
Dr. Pearlman is a world-renowned, dual board-certified facial plastic and reconstructive surgeon with decades of experience specializing in rhinoplasty in Manhattan, New York. Having performed over 7,000 successful rhinoplasty surgeries, he’s empowered thousands of people to live more confidently.
Beyond his board certifications through the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology-Head and Neck Surgery, his attention to detail in everything he does sets him apart. He takes the time to listen first, understanding your unique struggles and aspirations to give you the personalized attention you deserve.
He ensures your results are not only beautiful, but also authentic to who you are.
Persistent in the pursuit of perfection, his commitment to excellence spans beyond our practice. More than an exceptionally skilled and highly recognized surgeon, Dr. Pearlman is a humanitarian and Clinical Professor at Columbia University College of Physicians. He leads the leaders in the plastic surgery industry, educating the next generation of surgeons on his innovative and proven techniques in open and closed rhinoplasty. In NYC, Dr. Pearlman embodies the rare balance of innovation and empathy that defines the very best in plastic surgery.
Your Rhinoplasty Consultation
We begin each and every one of our surgical and nonsurgical procedures with an in-depth consultation. Here, we discuss your unique concerns, desired results, and lifestyle factors such as your age, general health, and capacity for downtime. This allows us to determine the appropriate rhinoplasty technique and tailor your surgical plan to align with your specific needs.
To identify the most effective rhinoplasty method, Dr. Pearlman performs an in-depth assessment of your facial anatomy. Only after completing a comprehensive face and nose examination and discussing your situation do we provide recommendations, empowering you to move forward with confidence.
Are You a Candidate for Rhinoplasty?
We truly understand the power that balanced facial features can have on your overall appearance, as well as how your appearance affects your self-esteem. However, it is also our job to ensure you receive the optimal procedure for your desired results.
You may be an ideal candidate for open or closed rhinoplasty in NYC if you:
- Are generally in good health
- Do not smoke
- Have realistic expectations
To ensure the nose has fully matured, female patients must be aged 15 or older, and male patients must be 16 or older.
2D and 3D Computer Imaging
At Pearlman Aesthetic Surgery, precision is everything. To visualize your potential outcomes, Dr. Pearlman uses state-of-the-art 2D imaging in all rhinoplasty patients and Vectra 3D imaging technology for primary rhinoplasty patients.
This simulation allows you to envision how your aesthetic goals transfer to your features, rather than relying on a photo of someone else. Blending artistry with innovation, we provide the clarity and peace of mind you need to move forward.
Rhinoplasty Procedure
Prior to the procedure, Dr. Pearlman will take photos with your consent in order to document the before and after of the procedure. These will not be shared without your written permission.
For rhinoplasty surgery, we place you under general anesthesia or twilight sedation to perform the procedure. Typically, a primary rhinoplasty takes 1.5 to 3 hours to complete, while a complex revision rhinoplasty may take up to 6 hours. Dr. Pearlman will either perform an open or a closed rhinoplasty, depending on his expert opinion of what’s best for you.
Rhinoplasty Recovery
Rhinoplasty is an outpatient procedure, which means you’ll be able to go home once we clear you after surgery. Dr. Pearlman, our patient care coordinator, and the rest of our skilled staff equip you with detailed post-operative care instructions before you leave. Following these instructions not only streamlines healing after an open or closed rhinoplasty in NYC, but also supports your long-term outcomes.
Keep in mind that you will need to arrange for transportation home after the procedure, as the anesthesia takes time to wear off. Typically, Dr. Pearlman recommends taking at least a week and a half off from school or work to recover. Regardless of whether you undergo an open or closed rhinoplasty, you will experience some swelling and bruising. This is a natural healing response, and it typically resolves within 7 to 10 days.
During your recovery, prioritize eating a balanced diet with limited processed foods, caffeine, and alcohol, which can increase inflammation. Be gentle with your nose, and avoid applying pressure to the area, wearing sunglasses, or engaging in physical activity until cleared.
Rhinoplasty Results
You can expect to see preliminary results within a few weeks of your rhinoplasty, once the majority of post-operative swelling has dissipated.
However, your nose continues to heal beneath the surface, and residual swelling continues to resolve over the following 3 months. We advise all patients that after a year, their results are nearly final, although individuals who have undergone tertiary revision surgery and/or have thicker skin may take longer.
Answering Your Questions About Rhinoplasty Surgery
We understand that choosing to undergo rhinoplasty is a life-changing decision, and it’s natural to have questions. Dr. Pearlman thoroughly explains his recommendations and provides guidance and support before, during, and after your surgery, but below, we’ve answered patients’ most common questions about open and closed rhinoplasty in NYC.
Is rhinoplasty scarring noticeable?
In the hands of an experienced and highly skilled surgeon, no. Dr. Pearlman has mastered the art and science of rhinoplasty, leaving a nearly invisible trace, regardless of the technique.
While the incision from an open rhinoplasty is visible immediately after surgery, Dr. Pearlman’s meticulous techniques promote seamless healing. Within 4 to 6 months, scars fade beautifully. Once you’ve healed, someone must look up your nose and into your nostrils—closely enough to count your nose hairs—to notice any signs of surgery.
Will people be able to tell I’ve had a nose job?
When you come to Dr. Pearlman, whether others notice that you’ve undergone rhinoplasty depends entirely on the kind of change you hope to achieve. Some patients desire a dramatic change, and close friends and family members may notice an improvement in symmetry and/or shape. Others seek subtle refinement, in which case people may notice that your features appear more balanced and you look more confident, without being able to pinpoint what’s changed.
In either case, Dr. Pearlman ensures that your results look authentic to you. Through meticulous techniques, your nose simply becomes a feature that complements and elevates your natural beauty, establishing greater overall facial harmony. Regardless of whether you undergo an open or closed rhinoplasty in NYC, our goal is to leave you looking confident, not like you’ve had surgery.
Does rhinoplasty require breaking the nose?
Sometimes, osteotomies are necessary. While it’s more subtle and controlled than “breaking” a bone, this process consists of surgically reshaping the nasal bones to straighten, narrow, or refine the nose. In Piezo ultrasonic rhinoplasty, we often use the Piezo device to more gently mobilize the nasal bones.
Dr. Pearlman’s precise approach to osteotomy does not make the rhinoplasty recovery process more painful or extended, nor does it weaken the nose once healed. In some cases, we may use modern techniques, such as a Piezo ultrasonic rhinoplasty or preservation rhinoplasty, to avoid osteotomies. Your surgical plan depends entirely on your anatomy and goals, but Dr. Pearlman only performs osteotomies if they will truly enhance your outcomes.
Trust the Expert Behind Thousands of Successful Rhinoplasties
The nose you’ve always wanted—and the confidence that comes with it—doesn’t have to be a dream. With unmatched experience, double board-certification, and a reputation built on natural-looking results, Dr. Pearlman is a trusted choice for open and closed rhinoplasty in NYC.
Schedule your consultation to discover what’s possible when you work with a leading plastic surgeon.
Have questions about what to expect or how to know if you’re ready for surgery? Explore our blog for more exclusive insights, including answers to patients’ most asked questions about nose reshaping in New York City, or use our virtual rhinoplasty tool for on-demand guidance.
We’re here for you at every stage of your journey, so don’t hesitate to contact us at any point.
