Beverly Hills plastic surgeon and revision rhinoplasty expert, Dr. William James Binder performs both procedures at his medical office in Beverly Hills. He says that “the closed rhinoplasty is nearly a lost art. It is significantly more difficult for the surgeon to learn, and demands a steeper, longer learning curve than the open approach.” Newer surgeons generally prefer the open technique, because it done under direct vision, but can lead to scarring, and longer recovery time. The closed technique on the other hand, is performed from the inside of the nose, so there are no visible signs of scarring, and less likely to have long-term unpredictability. Beverly Hills revision rhinoplasty expert Dr. Binder prefers the closed technique, because although it is significantly more difficult to perform, it is a more traditional form of rhinoplasty in which the results are much more sophisticated, predictable, and beautiful in the end.

When asked whether to perform Rhinoplasty with a closed or open approach, Dr. Binder’s answer is: "I can perform Rhinoplasty either through a closed or open approach. However, I reserve the open Rhinoplasty approach for only very special circumstances. In most primary Rhinoplasty or majority of Beverly Hills Revision Rhinoplasty patients, I believe that the experienced surgeon should have the capability to perform Rhinoplasty through the closed approach, which is how I perform the majority of my cases. I have seen too many scars underneath the nose that do not heal properly as a result of the open Rhinoplasty technique. If these scars do not heal well, it is extremely difficult to correct them and they can potentially remain permanently visible.”

So why are so many surgeons using the open technique in Beverly Hills Rhinoplasty? Dr. Binder claims that most training programs do not have sufficient case loads to teach both methods. Many new surgeons opt for the open technique to access the nasal skeleton for easy viewing. "In practicality, it can also be problematic, since the open technique can, in some cases, cause significantly more scarring, skin shrinkage, and long-term unpredictability than the closed techniques,” says Dr. Binder.