Rhinoplasty Techniques: Closed, Open or Liquid Rhinoplasty



Medically Reviewed April 2023, by Premjit Randhawa - Consultant Aesthetic Rhinoplasty Surgeon

Here we are taking a deep dive into the key differences between rhinoplasty techniques so you can choose from a surgical or non-surgical rhinoplasty procedure. Nose reshaping, or rhinoplasty, is an increasingly popular cosmetic procedure and with the introduction of non-surgical techniques, is becoming more and more accessible.

Rhinoplasty (also known as nose job) is one of the most complex specialist procedures in plastic surgery. There is significant variation in the anatomy of the nose between individuals meaning that the Plastic Surgeon needs to have a deep understanding of the complex structures that make up the nose, and how they can be altered in any given case to achieve the desired result.

There are a range of rhinoplasty techniques or approaches that can be used by an experienced surgeon to achieve the patient’s perfect nose shape depending on the circumstances.

Closed Rhinoplasty Technique

In the closed approach, incisions are made inside the nostrils called marginal incisions. It is through these marginal incisions that alterations to the shape and contour of the nose are made. Closed rhinoplasty is associated with reduced swelling and recovery time and is most suitable for patients who require less significant nose reshaping.

You can read more about the rhinoplasty recovery process here.

Difference between surgical and non-surgical rhinoplasty. Choosing surgical or non-surgical rhinoplasty. Rhinoplasty techniques.


  • Less invasive procedure
  • No visible scarring
  • Reduced recovery time
  • Less swelling and bruising following surgery
  • Shorter operating time


  • Anything more than subtle reshaping may not be possible
  • It can be more difficult for the surgeon to examine the anatomy of the nose
  • Revision surgery can be limited

Open Rhinoplasty Technique

In the open approach, the marginal incisions made in the closed approach are repeated. In addition, an incision is made across the bridge of tissue that connects the two nostrils at the bottom of the nose (the columella). This incision joins the incisions made inside the nostrils. The open approach forms an envelope of tissue that can be folded upwards to expose the nasal cartilage and bone. The surgeon is then able to examine the anatomy of the nose and perform the precise reshaping process.

Although open rhinoplasty involves making an incision on the external visible portion of the nose and scarring is possible, with excellent surgery and postoperative care these incisions often heal well. Any scarring from open rhinoplasty would not be easily noticeable since it would be located on the underside of the nose.

Difference between surgical and non-surgical rhinoplasty. Choosing surgical or non-surgical rhinoplasty. Rhinoplasty techniques.


  • Less invasive procedure so the surgeon is able to examine the anatomy of the nose in more detail
  • The nature of the procedure allows for more precise techniques
  • It is possible to make more significant changes to the shape of the nose
  • It is possible to make changes to the tip of the nose if required


  • The potential for visible scarring
  • Longer operating time
  • More swelling and bruising following surgery

Septorhinoplasty Technique

The septorhinoplasty technique can be used to correct septal deviation which can cause problems with airflow through the nose. The septum is the structure that divides the nose internally into left and right halves. In this procedure, incisions are made in the internal lining of the nose to expose the underlying cartilage and bone. Any corrections that need to be made to the shape of the septum can then be completed. Septorhinoplasty also involves correcting structural problems in other parts of the nose and is not reserved exclusively for septal defects.

Rhinoplasty-Tip Surgery Technique

The nasal tip is a complex structure and alterations to it can change the overall appearance of the nose. This procedure is most suitable for individuals who feel that the tip of their nose is too broad, narrow, bulbous or asymmetrical, or if the nostrils are too large. The plastic surgeon is able to remove or reshape the cartilage to ensure that the nasal tip is in proportion with the other parts of the nose and achieve a result that fits with the other facial features in harmony.

General anaesthesia or local anaesthesia with sedation?

So far, we have covered some of the technical differences between the different types of rhinoplasty, as well as some advantages and disadvantages of the open and closed approaches.

One thing in common between all types is that anaesthesia is required, and although general anaesthesia is considered safe and complications are rare, there is some level of risk involved.

With rhinoplasty, there are two anaesthetic options:

  • General anaesthesia - involves the use of anaesthetic agents to render a patient unconscious and unable to feel pain. A tube will be inserted into the windpipe to assist the patient to breathe. A specialist anaesthetist is present throughout the surgery to monitor the patient.
  • Local anaesthesia and sedation – involve administration of a local anaesthetic agent to prevent pain sensations alongside a combination of medicines to make the patient feel relaxed.

Each method has its associated advantages and disadvantages and the decision on which method is best should be considered on an individual basis.

rhinoplasty patient before & after by Mr Premjit Randhawa. Difference between surgical and non-surgical rhinoplasty. Choosing surgical or non-surgical rhinoplasty. Rhinoplasty techniques.

What is the difference between surgical or non-surgical rhinoplasty?

To choose between surgical or non-surgical rhinoplasty, you need to know the difference between these treatments. Surgical Rhinoplasty involves making incisions in the skin and making changes to the shape of the bone and cartilage in the nose. Non-surgical rhinoplasty offers a less invasive alternative to surgical interventions for those searching for a way to correct, enhance or alter the shape and appearance of the nose. Dermal fillers are injected under the skin in specific locations to alter the proportions and contours of the nose to give the illusion of a thinner, straighter or more symmetrical appearance.

At our sister company sk:n, only qualified medical practitioners carry out our injectable treatments so you can rest assured you are in safe hands.

Surgical or non-surgical rhinoplasty: The pros and cons

As with any aesthetic procedure, there are pros and cons that make the different options more suitable for some patients than others.

Non-surgical techniques provide solutions that are less costly, associated with fewer risks and require shorter recovery periods. Whereas surgical facilitates a more drastic, permanent change to the shape of the nose.

The nature of surgical Rhinoplasty means that it is associated with greater risk than non-surgical, especially when performed under general anaesthetic. A study published in The Aesthetic Surgery Journal found that the overall complication rate of surgical Rhinoplasty was 0.7%[1] and some of the risks include:

  • Infection – If the incision sites are not cared for and cleaned properly after surgery, the chance of infection is increased.
  • Breathing disturbance – Rhinoplasty which aims to reduce the overall size of the nose is associated with an increased risk of breathing disturbance.
  • Skin numbness – Usually a temporary side effect of invasive surgery, that commonly resolves during the recovery period.
  • Bleeding – As with any surgery, making incisions in the skin and soft tissues carries the risk of bleeding.

Non-surgical rhinoplasty is considered to be safe and complications are rare but there is a risk of swelling, bruising and redness around the injection sites. A safety review published in The Journal of Facial Plastic Surgery and Aesthetic Medicine found that serious events occur in just 0.2% of cases when administered by a Doctor[2].

Nose fillers are a series of small injections of gel which will are applied to the soft tissue in the nose to shape, straighten and contour. Injecting the dermal filler takes less than half an hour and the results will not only be instant, but last around 12 months.

Surgical or non-surgical rhinoplasty: Who is suitable?

Surgical is most suitable for patients who are searching for a permanent solution to their cosmetic concerns and where more significant changes are required. Non-surgical rhinoplasty is a suitable alternative for many patients looking to make minor adjustments to the contours of the nose or smoothen small bumps and irregularities.

However, there are circumstances where it would not be possible to achieve a patient’s desired results with non-surgical Rhinoplasty. Some examples of when this might be the case include:

  • Excessive rotation of the tip of the nose
  • A large hump or bump on the bridge of the nose
  • Significant deviation of the nose
  • Nasal reduction

In these cases, surgical intervention may be more appropriate. In any instance, the most suitable approach for your aesthetic goals should be discussed with your expert at The Harley Medical Group during a free no-obligation consultation. You can read about the most important questions to ask your Rhinoplasty surgeon here.

If you would like to explore how non-surgical Rhinoplasty can help you to achieve your desired results, sk:n, the UK’s leading skin clinic, provides non-surgical nose job treatments administered by highly trained and experienced expert clinician injectors. Together, we hope to help you make the right decision about whether to choose surgical or non-surgical rhinoplasty and which rhinoplasty technique to choose.

Discover Brandon's rhinoplasty surgery journey with Mr Premjit Randhawa;


1. Layliev J, Gupta V, Kaoutzanis C, Ganesh Kumar N, Winocour J, Grotting JC, Higdon KK. Incidence and Preoperative Risk Factors for Major Complications in Aesthetic Rhinoplasty: Analysis of 4978 Patients. Aesthet Surg J. 2017 Jul 1;37(7):757-767. doi: 10.1093/asj/sjx023. PMID: 28472446.

2. Rivkin A. Nonsurgical Rhinoplasty Using Injectable Fillers: A Safety Review of 2488 Procedures. Facial Plast Surg Aesthet Med. 2021 Jan-Feb;23(1):6-11. doi: 10.1089/fpsam.2020.0291. Epub 2020 Dec 2. PMID: 33270519.

You can read more about rhinoplasty at The Harley Medical Group here, or book a free consultation to begin your nose reshaping journey.

Posted February 16, 2022
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