Many patients are concerned about the possibility of scarring with Open Rhinoplasty procedures; however, over the past 20 years performing Open Rhinoplasties, patients almost never complain or are concerned with a post-operative Open Rhinoplasty incision.
The trick to create a close to scarless Open Rhinoplasty incision is placing a meticulous inverted V incision at the midcolumellar level, followed by a meticulous incision closure using a fine suture such as 6-0 nylon. Nevertheless, I have also revised Open Rhinoplasty incisions, made by other surgeons, that where either poorly planned or poorly sutured. Unfortunately, many surgeons who have not been formally trained in an Open Rhinoplasty technique will not offer this approach and will also criticize it for potential scarring.
Notwithstanding, the Open Rhinoplasty approach offers direct visualization of the soft nasal tissue, cartilage and bony structures. This is particularly important for Ethnic Rhinoplasty, African-American Rhinoplasty or Revision Rhinoplasty. Closed Rhinoplasty, although effective with simpler procedures such as Dorsal Hump Reduction, offers less visual advantages and precision in Rhinoplasty. Below are examples from my patients showing Open Rhinoplasty incisions healing after 1 year or more.