Open rhinoplasty is a nose surgery technique in which a small incision is placed on the narrow strip of tissue between the nostrils (the columella) so that the nasal skin can be lifted and the nasal framework seen directly. At İstanbul Burun Estetiği, our clinic in Bakırköy, Istanbul, considers the open approach when the nose has complex anatomy, the tip needs detailed reshaping, there is marked asymmetry, or a revision operation is planned, because direct vision allows more precise, controlled work. This page explains how open rhinoplasty is performed, who it may suit, its advantages and risks, what recovery looks like, and what to expect at the consultation.
What is open rhinoplasty?
Rhinoplasty is a surgical procedure that changes the shape, size or breathing function of the nose. It is carried out with one of two main techniques: open or closed. In open rhinoplasty, in addition to the incisions made inside the nostrils, a small skin incision of a few millimetres, usually step-shaped or V-shaped, is placed across the columella. Through this incision the skin and soft tissue envelope of the nose is lifted like a lid, so the cartilages of the tip and the bone and cartilage of the nasal bridge can be seen directly.
The word “open” refers to the fact that the nasal framework is openly visible to the surgeon. This view is especially helpful in the fine, complex structure of the nasal tip, which depends on the balance of many small parts: the lower lateral cartilages, the ligaments that tie them together, and the skin covering them. Changing one part without disturbing the others is easier when each structure can be clearly seen.
Open rhinoplasty is not only for cosmetic changes. Because it gives a direct view, it can also help correct breathing problems such as a deviated septum, nasal valve narrowing or collapse of the nostril wings. For this reason, nasal function is always assessed together with appearance when an operation is planned.
How is open rhinoplasty performed?
Every nose is different, so the details of each operation vary. The general flow below is for information; your personal plan is set by our doctor at the consultation.
1. Anaesthesia
The operation is usually performed under general anaesthesia. In some selected cases a combination of sedation and local anaesthesia may be considered. The type of anaesthesia is planned with the anaesthetist according to your health history, the extent of surgery and your preference. Tests such as blood work may be requested beforehand.
2. Making the incisions
After the necessary incisions inside the nose, a small incision is added across the columella. Its design is planned carefully so that the later scar is as inconspicuous as possible. The skin is then lifted off the nasal framework.
3. Assessing and reshaping the framework
Once the skin is lifted, the tip cartilages and the bone and cartilage of the bridge are seen directly. Depending on the goal, excess cartilage or bone may be reduced, a bump on the bridge removed, or the tip repositioned or supported. When needed, cartilage grafts taken from the septum, the ear or, occasionally, the rib may be used to support or shape the nose. The need for grafts and their source are planned in advance and discussed at the consultation.
4. Adjusting the bones (if needed)
If the bridge is wide or crooked, the bones can be repositioned in a controlled way. This is called an osteotomy. It is not needed in every case and depends on the structure of the nose and the planned correction.
5. Closing and splinting
When shaping is complete, the skin is draped back, and the columella incision is closed with fine stitches. An external splint is placed over the nose, and in some cases silicone supports or packing are placed inside. The splint is usually removed around the first week at our clinic.
The length of surgery varies with its extent. A primary rhinoplasty commonly takes about two to four hours; revision or graft-heavy cases may take longer.
When is the open technique preferred?
Open and closed techniques are not “better” or “worse” than each other; the right choice depends on the structure of the nose, the planned correction and the surgical plan. Situations in which the open technique is often considered include:
- Complex nasal tip anatomy: A wide, asymmetric, drooping or “round” tip is easier to plan for when the cartilages are directly visible.
- Marked asymmetry: When the left and right sides differ clearly, both sides can be compared and corrected together.
- Cases needing grafts or support: When grafts are used to support the tip or bridge, placing and fixing them precisely is easier with direct vision.
- Revision rhinoplasty: In a nose that has been operated on before, the tissues and anatomy have changed and scar tissue is present, so direct vision is often preferred. See our revision rhinoplasty page for details.
- Combined functional and cosmetic correction: When breathing problems such as septal deviation or valve narrowing are addressed with cosmetic change, the open approach can help. Our septorhinoplasty page is relevant here.
- Advanced tip shaping: Changing tip projection or rotation with fine suture and graft techniques is often easier through an open approach.
On the other hand, limited corrections, such as reducing a small bump on the bridge, may be done well with the closed technique. Our doctor examines your nose at the consultation and explains which approach suits you and why.
Advantages of open rhinoplasty
The benefits of the open approach are most apparent in complex operations:
- Direct vision: The nasal framework is fully visible, so cartilage and bone can be assessed in a more controlled way.
- Use of both hands: Because the skin is lifted, the surgeon can work with both hands, which helps with fine suturing and graft placement.
- Assessing symmetry: Structures on both sides are seen side by side, which makes planning for asymmetry easier.
- Placing and fixing grafts: Grafts for the tip or bridge can be positioned and secured more precisely.
- Planning in revision and complex cases: Recognising altered anatomy and scar tissue clearly is important.
- Addressing internal functional problems at the same time: Corrections for breathing can be combined with cosmetic changes.
These advantages do not mean a result is guaranteed. As with any operation, healing differs between people, and the final result is influenced by skin thickness, tissue structure, healing speed and adherence to aftercare.
Disadvantages and risks
Open rhinoplasty is a technique used safely and widely; however, like any surgery it has disadvantages and risks, and these should be discussed openly before surgery.
Points specific to the technique
- Columella incision: There is a fine incision on the outside of the nose. It fades in most people over time, but scarring varies and it may occasionally remain noticeable.
- Swelling that lasts longer: Tip swelling can last somewhat longer with the open technique than with the closed technique, and the tip can take months to reach its final shape.
- Temporary numbness of the tip: Reduced sensation around the tip and upper lip may occur; it usually improves over weeks to months.
- Slightly longer surgery: Cases that need direct vision and detailed shaping may take longer.
Risks common to nose surgery
- Bleeding and bruising
- Infection
- Complications related to anaesthesia
- Persisting or new difficulty breathing
- Asymmetry or not achieving the intended shape
- Changes in shape over time at the bridge or tip
- Septal perforation (rare)
- The need for revision surgery
These risks are assessed individually at the consultation. Smoking, certain medicines and chronic conditions can affect them, so sharing your full health history is very important.
Comparing the open and closed techniques
The table below compares the two techniques in general terms. The right method is decided after examination in each case.
| Feature | Open technique | Closed technique |
|---|---|---|
| Incision | Inside the nose + small cut on the columella | Inside the nose only |
| Doctor's view | Direct view of the nasal framework | Working through a limited opening |
| Often considered for | Complex tip anatomy, marked asymmetry, revision | Limited, specific corrections |
| Visible external scar | A fine line on the columella (usually fades over time) | None |
| Swelling duration | Can last somewhat longer | Can be somewhat shorter |
| Graft and support placement | More controlled | Possible but may be limited |
For more about the closed approach, see our closed rhinoplasty page.
Consultation and preparation before surgery
A good rhinoplasty begins at the consultation, well before the operating room. At our clinic the first meeting covers the following:
- Your expectations: It is important to explain clearly what you want to change, what you want to keep, and your goals. Showing photographs can help, but because every face is different, an exact copy is not the aim.
- Health history: Previous operations, medicines you take, allergies, bleeding disorders and chronic conditions must all be shared.
- Nasal examination: The structure of the nose, skin thickness, septum, nasal valves and breathing function are assessed.
- Planning: The reason for the recommended technique, alternatives, risks and the expected recovery are explained.
- Tests: Blood tests and, where needed, further imaging may be requested for anaesthetic safety.
Before surgery
- Smoking and nicotine products should be stopped for a period before and after surgery; our doctor will tell you how long.
- Some medicines and supplements that may increase bleeding must be stopped before surgery. Always ask your doctor which medicine to stop and when; do not stop medicines on your own.
- You will need someone to accompany you on the day of surgery and help at home in the first days.
- Fasting instructions before anaesthesia must be followed.
Recovery: day by day and week by week
Recovery is one of the most common questions. The timeline below is a general framework; our doctor's instructions always take priority. For more detail, see our recovery page.
| Period | Commonly seen | General advice |
|---|---|---|
| First 24–48 hours | Nasal blockage, slightly bloody discharge, swelling | Keep your head raised, rest, take the medicines advised |
| Week 1 | Bruising, splint, columella stitches | Splint and stitches are usually removed now; do not blow your nose |
| Weeks 2–3 | Bruising fades noticeably, swelling continues | Light daily activities are usually possible |
| Weeks 4–6 | Most swelling settles | Avoid heavy exercise and activities that put pressure on the nose |
| Months 3–6 | Tip swelling slowly goes down | Continue check-ups |
| Month 12 onward | Final shape settles | Long-term follow-up |
Caring for the columella incision
The stitches across the columella are usually removed within the first week. The area may look slightly red and swollen at first. Keeping it clean and moist as our doctor advises, protecting it from the sun and avoiding friction help scar quality. Sunscreen is especially important because nasal skin can stay sensitive for a long time.
Why does swelling last longer?
Because the skin and soft tissue are lifted in the open technique, lymphatic drainage is temporarily disturbed, which can make the tip swell for longer. Most swelling goes down in the first weeks, but fine swelling can persist for months. This is normal and needs patience. The nose often takes 12 months or longer to reach its final shape.
When to seek help immediately
Contact the clinic or an emergency service without delay for uncontrolled bleeding, high fever, severe and increasing pain, shortness of breath, or redness and pus around the nose.
Everyday life and aftercare
The success of an operation is not decided only in the operating room; care during recovery also affects the outcome. The tips below are general information and do not replace your doctor's personal instructions.
- Head position: Keeping your head raised with pillows in the first days helps swelling settle. Bending forward and heavy lifting increase pressure around the nose and are not advised in the first weeks.
- Nose care: Blowing the nose is forbidden in the first weeks. Saline or other solutions advised by our doctor are used for care inside the nose.
- Glasses: Glasses can press on the nose, so for several weeks special supports or alternatives are used as our doctor advises.
- Washing and make-up: Water and friction should be kept away from the splint and the columella incision. Our doctor will explain exactly how to wash your face and hair.
- Sun protection: Nasal skin can stay sensitive; avoiding sunburn matters for scar quality and skin colour.
- Diet and fluids: A balanced diet and plenty of water support healing. Salty foods can increase swelling, so they may be limited in the first weeks.
- Sleep: Sleeping on your back with your head raised avoids accidental pressure on the nose.
- Check-ups: Attending your check-ups regularly helps your recovery be monitored and problems be noticed early.
Differences in recovery between people are normal and depend on factors such as skin structure, age, general health and the extent of surgery.
Will the scar really be visible?
One of the most common questions is whether the columella scar will show. The incision is very small and sits between the nostrils, under the tip. In most people the scar fades considerably within a few months and is not noticeable in daily life. However, scar quality depends on skin type, healing tendency, sun protection and care, and a specific outcome cannot be guaranteed. Our doctor discusses this openly at the consultation.
Who is a suitable candidate?
Rhinoplasty suits people who are physically and psychologically ready and whose expectations are realistic. Generally, the following are considered:
- Growth is complete; surgery is therefore usually planned after adolescence.
- General health is suitable for surgery and anaesthesia.
- Willingness to stop smoking and nicotine before and after surgery.
- Understanding that surgery is a planned improvement, not a promise of perfection.
- Being able to set aside time for recovery and attend follow-up checks.
Suitability is decided only after an in-person examination. The information on this page is general and does not replace personal medical advice.
Common misunderstandings about open rhinoplasty
“The open technique always leaves a permanent scar.”
The columella incision is small and fades in most people. Scarring depends on skin type and healing tendency; no technique can promise no scar, but it is not true that the open technique always leaves a noticeable one.
“The closed technique is safer.”
Safety depends on how well the technique fits the case and on the experience of the team, not on the name of the technique.
“The nose takes its final shape straight away.”
When the splint comes off the nose is still swollen. Most swelling goes down within weeks, but the tip often takes a year or more to settle.
“The nose in a photograph can be made exactly for me.”
Facial proportions, skin thickness and cartilage structure differ between people, so another person's nose is not an exact target. The aim should be a balanced nose that suits your own face and keeps breathing function.
Open rhinoplasty at our clinic
İstanbul Burun Estetiği is a rhinoplasty clinic in Yalı Ataköy, Bakırköy, Istanbul. Our open rhinoplasty process has four stages:
- Consultation: Your expectations, health history and nasal structure are assessed together with our doctor.
- Planning: The recommended technique, possible risks and alternatives are shared with you, and needed tests are requested.
- Surgery: The planned procedure is carried out under suitable anaesthetic conditions.
- Follow-up: The splint and stitches are removed at the clinic, followed by planned long-term check-ups.
For patients travelling from outside Istanbul or from abroad, accommodation, the length of stay for the first check-up and follow-up arrangements after returning home should be planned in advance. You can ask us about these when you arrange a consultation.
What affects the cost of open rhinoplasty?
The cost of open rhinoplasty is not one fixed number. The extent of surgery, whether it is a primary or revision operation, the need for grafts, the type and length of anaesthesia, hospital and theatre conditions, and post-operative check-ups all affect the price. Because we cannot state a fair amount without an examination, we do not publish a figure here; the exact amount is set in a written quote after your consultation with us. We put in writing what the quote includes and excludes. See our cost page for more.
Frequently asked questions about open rhinoplasty
In open rhinoplasty, a small incision on the columella is added to the incisions inside the nose, and the skin is lifted so the framework is seen directly. In closed rhinoplasty all incisions are inside the nose and no external incision is visible. Which one suits you depends on your nasal structure and the planned correction.
No. Both techniques can be applied successfully in the right case. The open technique helps in complex tip and revision cases, while the closed technique may be enough for limited corrections. What matters is choosing the technique that fits your nose.
You feel no pain during the operation because it is done under anaesthesia. In the following days most people report mild to moderate discomfort that can be managed with painkillers; experience varies.
A primary open rhinoplasty commonly takes about two to four hours. Revision cases or those needing grafts may take longer.
The incision is very small and fades in most people. Scarring varies from person to person; sun protection and good care help, but no specific result can be guaranteed.
Usually at around one week; timing depends on our doctor's assessment.
For desk work most people return in about 1–2 weeks; physical jobs may take longer. This depends on our doctor's assessment.
Heavy exercise and sports with a risk of knocks to the nose are usually avoided for several weeks. Gentle walking may be possible earlier with our doctor's approval.
Most swelling settles in the first weeks, but the final shape often takes 12 months or longer. Tip swelling may go down more slowly after open surgery.
It can both improve and worsen breathing. Nasal function should be assessed before surgery and included in the plan. If needed, the septum can be corrected in the same operation.
It is often chosen in revision because tissues are changed and scar tissue is present. The decision is still made at the consultation according to the current structure of the nose.
Reach us by phone, WhatsApp or email to arrange a consultation. Our clinic is in Yalı Ataköy, Bakırköy, Istanbul.