Both open and closed rhinoplasty can be extremely effective. The doctor will determine the right technique for each patient, based on the natural shape of the nose and the goals for surgery. If the patient desires dramatic changes, or if the doctor is performing post-traumatic rhinoplasty, an open technique may work best. This method gives the doctor access to a larger part of the nose. In many cases, it also helps him or her to make small adjustments to the nasal tip. If a patient wants to address the bridge of the nose, closed rhinoplasty may work well. However, because each patient is different, there are no hard and fast rules regarding the "right" procedure to use.

Case 37: Achieving a beautiful, natural change in an already beautiful woman is one of the great challenges we love in rhinoplasty. In front view you see a beautifully defined, natural change that simply looks great. Then on profile and 3/4 views, you see an elegant change where the tip is deprojected (made smaller) but retains a beautiful, natural aesthetic- this is finesse rhinoplasty.
Dr. S. Valentine Fernandes, the Conjoint Senior Clinical Lecturer, at the Department of Otorhinolaryngology, Newcastle University, conducted a comprehensive study about the risks of rhinoplasty. According to Fernandes, the complication rate of nose surgery falls between 4 and 18.8 percent. While this may seem an alarming number, Fernandes reports that there is a much lower 1.7 to 5 percent risk of life threatening complications. He also notes that the complication rate falls in proportion to the doctor's surgical experience.
Although everyone heals at a different rate, most people will have very few signs of surgery at two weeks after rhinoplasty and feel comfortable returning to work. At this time most of the bruising has gone but there may be still some dark circles under the eyes that can be covered up with make up. There is usually some swelling on the tip of the nose and along the sides of the bridge. This will mostly be obvious to you and your surgeon but not the average person in the public.

Case 72: This patient had sustained a nasal fracture that caused a significant deviation of her nose. The fracture was corrected along with a septoplasty to improve breathing. Loss of tip support after the injury made her hump look more prominent and her tip felt more droopy. The bump was smoothened and her tip angulation restored to create the softer, more feminine profile she wanted. At the same time, fat transfer to the cheek and under eye area and subtle neck liposuction substantially improved the flat cheek and mid-face contour that previously made her feel hollowed and tired looking without makeup.

Case 22: This young woman was happy with her profile but wanted to reduce nasal width, tip boxiness, and nostril flare on front and three-quarter views. The combination of narrowing her bridge, tip refinement, and nostril reduction helped bring her nose into balance. At the same time, fat transfer to the under eye hollows did a fantastic job of brightening her eyes and giving her a more youthful look.


As stated above, these complications are unlikely. However, patients can take steps to reduce their risks even further. First, they should choose a qualified surgeon, according to the guidelines listed above. Selecting an outstanding doctor, who maintains proper safety standards, can minimize the chances of infection, perforation, and other difficulties. An experienced surgeon can also ensure aesthetically pleasing results.

Once your bone and cartilage have been resculpted, your surgeon pulls the skin back down and stitches it along the open-rhinoplasty incision across the columella (the tissue that links the nasal tip to the nasal base). “When done properly, that incision is extremely hard to see, once it’s healed,” says Dr. Miller. With a closed procedure, the incisions are made inside your nostrils, so there’s no visible scarring, and the sutures are usually dissolvable. 
As with almost all forms of plastic surgery, there is a possibility for scarring following rhinoplasty. In closed rhinoplasty, all incisions are made inside the nostrils and will therefore not leave behind any visible scars. In open rhinoplasty, an additional incision made across the columella may leave a small scar behind. Fortunately, due to the size and location of the incision this scar is usually unnoticeable. 

Case 72: This patient had sustained a nasal fracture that caused a significant deviation of her nose. The fracture was corrected along with a septoplasty to improve breathing. Loss of tip support after the injury made her hump look more prominent and her tip felt more droopy. The bump was smoothened and her tip angulation restored to create the softer, more feminine profile she wanted. At the same time, fat transfer to the cheek and under eye area and subtle neck liposuction substantially improved the flat cheek and mid-face contour that previously made her feel hollowed and tired looking without makeup.
This 37 year old female patient was troubled by the furrows that were appearing between her brows. These furrows are one of the unavoidable signs of aging, but we were able to roll back the clock a little with a quick application of Botox. We have more Botox ‘forehead lines’ before-and-after photos available at our clinic if you’re interested. You can also schedule your consultation for a Botox treatment, here.
Some people opt for a temporary nonsurgical nose job—also called a liquid rhinoplasty—with hyaluronic=acid-based injectable fillers, like Voluma or Restylane Lyft. This minimally invasive procedure can camouflage bumps, create more symmetry, or lift and build up the tip of your nose. This approach has its limitations though. “If you have a large nose, it’s not going to get any smaller with fillers,” says Dr. Miller, though changes in proportions can sometimes make it appear smaller. It also can’t fix a crooked nose.
Typically, at our clinic, rhinoplasty costs $8,500 ($7,500 + $1,000 for general anesthesia) plus tax. The total cost may vary based on your body and desired results, and whether you have any simultaneous procedures. In addition, clinic prices can vary based on factors such as the equipment they use, the clinic's accreditation, the surgical staff's skill levels, and the surgeon's experience.
Dr. Miller says it’s also important for patients to have realistic expectations. “It’s not a good idea to take a wide, thick nose and turn it into one that’s thin and tiny,” he says. “But if the steps are done properly, we can make the desired changes.” Thick nasal skin that makes it challenging to refine the nasal tip needs to be thinned out, for example. It’s important to find a board-certified facial plastic surgeon who specializes in ethnic rhinoplasties. 
Our plastic surgeons, injectors, and medical aesthetician individualize the cost of treatment for you depending on exactly what you need done. Every patient is different, and fees are based on the complexity of your case, as well as the amount of time it would take to do your procedure. We can only provide a definite quote after you have been seen for your consultation.
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