So what is the difference between an open and a closed rhinoplasty. Traditionally right rhinoplasty are performed closed. What is that mean? That means that incisions are made inside the nostrils and modifications are the underline structures will perform through those incisions only. Open in combinations with incisions along the septum to get more mobility and open rhinoplasty really just includes a small incision on what’s called the columella or the little central area of skin right here. It adds about a centimeter of incision which usually heals very well and provides tremendous access in visualization. In my opinion and in my practice I do the majority of my rhinoplasty’s open I find that I have more precise, more accurate results in my hands to do it an open approach which allows me to visualize structures very carefully precisely. I will start patient working on the engine of a core if my hands under the hood that’s the close technique but if I lift the hood I can visualize everything and then precisely what I need to do that’s an open technique.