Multiple terms exist to describe distinct forms of rhinoplasty procedures, including different types of rhinoplasty, different types of nose jobs, and types of nose surgery; however, not all terms refer to the same forms of procedures.
Some varieties of rhinoplasty refer to the access points that surgery opens to the internal structure of the nose; examples of this are closed and open rhinoplasty. Other varieties, including different rhinoplasty types and techniques, may refer to the specific technique or part of the surgery, as well as the goal of the procedure, or whether the surgery is revisionary.
The way vas are phrased is important. For example, if someone types in “best type of rhinoplasty,” they may want to look into different approaches to surgery; however, they may be looking to treat their dorsal hump or nasal tip, change the shape of the nose, clear a breathing obstruction, or help heal an injury from a past surgery.
This guide will cover the various rhinoplasty procedures, including different types of nose surgery, types of rhinoplasty techniques, and types of rhinoplasty surgery, and their key differences, as well as the factors that will most commonly dictate the rhinoplasty approach.
What Are the Different Types of Rhinoplasty?
What are Common Rhinoplasty Procedures?
To say it simply, there is no exhaustive list of every surgical variation in the rhinoplasty medical literature.
To best understand the various types of rhinoplasty, including types of nose jobs and different types of nose surgery, the various names of the procedures should be considered.
| Category | Examples | Definition |
|---|---|---|
| Surgical approach | Open, closed | Access method for the nose |
| Surgical technique | Preservation, Piezo, Ultrasonic | Preservation of specific structures |
| Area treated | Tip rhinoplasty, alar base surgery | Specific part of the nose reshaped |
| Purpose | Cosmetic, functional, reduction, augmentation | Reason for, or method of, changing the nose |
| Surgical history | Primary, revision | Number of previous surgeries |
| Patient/case | Ethnic, male, post-traumatic | Particular features or case |
| Combined procedure | Septorhinoplasty | Changing both cosmetic and functional aspects of the structure |
Many categories may be applicable to a patient simultaneously.
For instance, a patient may have a primary open rhinoplasty with an ultrasonic technique for tip refinement and dorsal hump reduction.
The terms can often be used in conjunction.
Main Types of Rhinoplasty Procedures
Open Rhinoplasty
For open rhinoplasty, a small incision is made on the external tissue between the nostrils, the columella, as well as some internal incisions.
This method allows the surgeon to see more of the framework of the nose and the structure of the nose.
An open approach is usually preferred on cases requiring a lot of structural work, complex tip changes, asymmetric balance, or when grafts are to be placed or when it is a revision surgery.
Potential advantages
An open approach is actually more useful when a surgeon needs to see more of the cartilage or the structures that support the nose.
What patients should know
There is no reason to consider open rhinoplasty more advanced than closed.
The type of approach should be based primarily on the anatomy and the correction that needs to be made and not on the perceived complexity of a particular approach.
Closed Rhinoplasty
For closed rhinoplasty, incisions are made entirely within the nostrils.
It is also referred to as an endonasal approach because it does not involve an external columellar incision.
Closed rhinoplasty is applicable to some patients where changes can be achieved through access to the structures internally.
With the surgeon’s discretion and the patient’s anatomy, it can be used for modifications involving the bridge, some corrections of the tip, and other structural changes.
Open vs Closed Rhinoplasty: The Best Option
When considering an open vs closed rhinoplasty, there is no best or winning option.
The main distinguishing feature is the access.
Closed rhinoplasty techniques involve incisions solely within the nasal cavity, whereas open rhinoplasty techniques involve incisions throughout the external nasal framework.
The determining factors include:
- the extent of the structural changes required
- previous nasal surgery
- anatomy
- surgeon’s discretion
- asymmetry
- the extent and type of grafting required
- the complexity of the surgery
Either approach can be justified, which is why patients should be wary of clinics which claim one approach is better than the other for all cases.
Piezo Rhinoplasty
The term piezo rhinoplasty refers to a specific technique which utilizes ultrasound to aid in the surgical reshaping of nasal bony structures.
It is not a technique that is applicable to all forms or phases of rhinoplasty.
Given the localized control that this technique may afford, piezo rhinoplasty does not render other techniques and forms of rhinoplasty unnecessary.
Ultrasonic Rhinoplasty
The terms piezo rhinoplasty and ultrasonic rhinoplasty are often used interchangeabley for the form of rhinoplasty that involves surgical reshaping of the nasal bones using ultrasound technology.
While there are often numerous searches for the term ultrasonic rhinoplasty, it is important that patients understand the term piezo rhinoplasty better describes the technique.
While it’s useful during specific surgical phases, ultrasound is not a dedicated tool of rhinoplasty.
Using ultrasound, patients may have either open or closed rhinoplasty for bone-related corrections.
Preservation Rhinoplasty
Preservation rhinoplasty seeks to alter the shape of the nose without losing some of the anatomical structures of the nose and its natural nasal anatomy.
More conventional approaches may involve the resection of certain structures and the subsequent relocation of those structures. Preservation techniques will seek to alter certain locations of the nose while retaining the majority of the structures.
Preservation rhinoplasty may be used on patients with appropriate nasal deformities; however, not all nasal shapes and deformities will lend themselves to a preservation approach.
Preservation rhinoplasty is best described as a surgical philosophy rather than as a technique that ranks above all others.
Tip Rhinoplasty
Tip rhinoplasty, or tip plasty, describes the alteration to the lower section of the nose.
A tip rhinoplasty may be performed to improve a nasal tip that is:
- too bulbous
- droopy
- too pole like or not
- projected equally
- as projected as
Tip rhinoplasty may require alteration of the cartilage of the nasal tip and may require maintaining the balance of the other nasal structures.
Reduction Rhinoplasty
The aim of reduction rhinoplasty is removal of excess nasal structures to achieve a balanced smaller nose, less pole like in appearance. This may include dorsal, tip, and other structures.
If too much material is taken away, an undesirable look can result. Therefore when designing an ideal shape of the nose for a patient, careful consideration should be given to the patient’s anatomical areas, balance, facial features, and facial harmony as a whole.
Augmentation Rhinoplasty
As opposed to reduction, augmentation rhinoplasty adds volume to certain areas or dimensions of the nose.
These areas may be the nasal bridge or the tip of the nose, where a patient may benefit from the addition of volume or support.
The addition may include the use of cartilage or other material, depending on the surgical plan.
These variations to a patient’s nose, either reductions or augmentations, is what is meant by a ‘nose job’.
Cosmetic Rhinoplasty
Cosmetic Nose Surgery
The goal of cosmetic rhinoplasty is to address the aesthetic concerns of a patient’s nose.
Some of the more common concerns are:
- dorsal hump
- nose width
- tip width or a bulbous tip
- tip of the nose
- nose asymmetry
- concerns with the shape of the nostrils
- concerns with the height or projection of the nose
- facial features and overall harmony and proportions of the face
When performing surgery of an aesthetic nature, one should keep in mind the function of the nose because of the relationship of the external appearance of the nose to the internal structures.
Functional Rhinoplasty
Nose Surgery for Breathing Problems
The goal of functional rhinoplasty is to address and/or correct structural concerns of the nose that may impair or limit the function of the nose, specifically the ability to breathe.
Some of the concerns may be the narrowing of the whole or part of the framework of the nose, including the nasal passages, or poor or inadequate support of the framework of the nose as a result of trauma.
In some cases, the surgery may be functional, and the external framework of the nose may impair the function of the nose and, as a result, the surgery may be of a cosmetic nature.
The distinction between functional and cosmetic rhinoplasty is often not clearly defined. In many cases, the surgery may be functional and cosmetic in nature.
Related Functional Procedures
- septoplasty
- turbinate reduction
- nasal septum
Septorhinoplasty
When addressing the concerns of the nose, a combination of septoplasty and cosmetic surgery of the nose is what is referred to as a septorhinoplasty.
In many cases, a person may want to have surgery to address aesthetic concerns of the nose and, in addition, have a deviated septum with impairing concerns of the function of the nose.
A septorhinoplasty is not a septoplasty.
Septoplasty addresses only the septum. In contrast, Septorhinoplasty can provide both internal functional and external aesthetic corrections to the nose.
Primary Rhinoplasty
Primary rhinoplasty indicates that the patient has never had a rhinoplasty performed. This also describes the patient’s surgical history, not a specific surgical method.
A primary rhinoplasty can also include open or closed techniques, tip and bridge surgery, functional surgery, or any of the other related procedures.
For this reason, the term primary rhinoplasty should not be directly related to other terms such as piezo rhinoplasty or closed rhinoplasty.
These terms relate to different elements of the surgery.
Revision Rhinoplasty
Secondary Rhinoplasty
Revision rhinoplasty describes a procedure which is performed to correct, both functionally or aesthetically, a nose previously operated on.
This can be for a number of reasons, including:
- persistent aesthetic concerns
- persistent or new asymmetry
- breathing issues
- problems related to healing post surgery
- dissatisfaction with the previous result
Revision surgery is more complex due to the altered anatomy and the presence of scar tissue.
The amount of required surgery also greatly varies from patient to patient.
Ethnic Rhinoplasty
There is no single Ethnic rhinoplasty technique. This term is generally used to describe rhinoplasty surgery that is specific to the patient’s ethnic background and is also constructed in a manner that strengthens the patient’s personal identity.
Aesthetic goals are also of paramount importance.
This approach aims to avoid applying a “one-size-fits-all” approach to rhinoplasty.
Asian rhinoplasty and terms of this nature all fit within this approach.
Male Rhinoplasty
Similar to other approaches, Male rhinoplasty surgery is also patient focused and is not a separate surgical technique.
Men may pursue the same concerns as any other patient such as dorsal hump, broad or bulbous tips, as well as nasal asymmetry or obstructions.
It’s important to recognize that male patients will not necessarily have the same nasal concerns, so surgical design should be based on male patients’ preferences and their facial aesthetics.
Post-Traumatic and Reconstructive Rhinoplasty
A nasal injury may involve trauma to the nasal bony and cartilaginous frameworks, bone and cartilage, nasal septum and air ne passages.
A post-traumatic rhinoplasty may be performed to improve both the aesthetic and functional results of a nose injury.
In some cases, a further reconstructive procedure may be needed to restore the nasal bony and cartilaginous frameworks.
These cases may be more complex than an uncomplicated cosmetic rhinoplasty, as the surgeon may need to address the structural concerns of the framework before focusing on the refinement.
What About Teenage Rhinoplasty?
Although there is no surgical age, teenage rhinoplasty is one of the more common nose job procedures mentioned throughout the various rhinoplasty procedures online.
The main concerns involve the teen’s proper physical development, the teen’s overall health, and the motivation and expectations of the teen.
Rhinoplasty should not be done to achieve a passing trend.
Each individual should be assessed for their own unique circumstance.
Non-Surgical Rhinoplasty
Although a liquid rhinoplasty is listed as one of the procedures of rhinoplasty, it is not a surgical rhinoplasty.
Non-surgical rhinoplasty refers to temporary contouring of the nose performed with dermal fillers.
Because of the limitation of fillers, it should not be perceived as a more convenient form of rhinoplasty.
Patients should address their concerns prior to comparing surgical and non-surgical rhinoplasty.
Rhinoplasty for Specific Nose Concerns
Most patients don’t start their surgery research with pinpointed questions.
They start with a concern.
Different concerns and types of nose can lead to unique combinations of rhinoplasty techniques.
Dorsal hump
Carving out a dorsal hump can lead to bridge surgery and even re-setting some of the surrounding nasal bones.
Bulbous or poorly defined tip
This can require the surgeon to reshape or support the nasal cartilage.
Wide Nose
Width can come from nasal bones, tip, or nostrils or a combination.
Deviated Nose
This can require surgery to the internal and external structures.
Breathing Problems
Cosmetic rhinoplasty may help some cases, but the surgeon must recognize the source of the problem.
This is why someone searching for a dorsal hump surgery or rhinoplasty to help breathing will have no easy answer.
Are Grafts, Osteotomies and Incisions Types of Rhinoplasty?
Cartilage Grafts and Surgical Procedures
This can also lead to cartilage grafts, osteotomies, and different rhinoplasty incisions.
These are more accurately described as components of the surgery, not different nasal jobs.
A cartilage graft can help support a different area of the nose.
An osteotomy is the surgeon’s controlled work of the nasal bone.
Incisions refer to the means of access to the surgical area.
Many of these methods will be used in combination for one rhinoplasty.
How Do You Choose the Right Type of Rhinoplasty?
Techniques should not be what you start with when selecting the appropriate type of rhinoplasty.
You need to start with the problem.
When assessing the problem the following needs to be considered:
- what needs to be changed
- skin thickness
- skin and cartilage of the nose
- bone constituency
- nasal tips
- airways and the ability to breathe
- previous injuries/trauma
- previous surgeries
- overall balance of the face
- the outcome you wish to achieve
- experience of facial plastic surgeons
Once all of this has been considered, the surgeon is now able to identify the most appropriate and the most applicable techniques for the surgery.
Marketing comes after planning and diagnosis, not before.
Which Type of Rhinoplasty Is Best?
There is no ‘best type’ of rhinoplasty.
One complex case may need to be approached with an open surgery, and another may need to be approached with a closed surgery.
There may be cases that are focused on the tip that may not benefit from the use of ultrasonic instruments and may be focused on other areas of the surgery.
Preservation rhinoplasty may be appropriate for certain anatomy, as anatomy is not one size fits all.
What Is the Safest Type of Rhinoplasty?
No type of rhinoplasty can be considered the safest type of surgery over another.
Safety is determined by the overall health of the patient, the type of surgery that has been deemed appropriate, the anesthesia that is used, the experience of the surgeon, the conditions of the surgery, the overall care given to the patient after the surgery.
Minimally invasive techniques may be deemed inappropriate, and choosing them simply because they may have the ‘safest’ type of rhinoplasty connotation may in fact be the wrong decision, and may not reduce the overall risk.
How Many Types of Rhinoplasty Are There? What Types of Rhinoplasty Are There?
There is no standard answer to this.
Rhinoplasties can be defined by the surgical technique used to achieve the desired outcomes, the techniques used, the purpose of the surgery, the area that the surgery focuses on, any previous surgeries, anatomy, and the overall condition of the patient.
What are the two main surgical approaches to rhinoplasty?
Generally, we can consider open and closed rhinoplasty to be the two main approaches to rhinoplasty.
What type of rhinoplasty should I get?
It is hard to determine which type of surgery is most appropriate without considering your anatomy and goals (including breathing and function), your history (including surgeries), and the changes you require.
Is closed rhinoplasty better than open rhinoplasty?
Closed rhinoplasty is not better than open rhinoplasty, and vice versa. Each technique is appropriate in different situations.
What is the difference between piezo and ultrasonic rhinoplasty?
Due to the use of ultrasonic technology for fine and controlled work on the nasal bone, the two terms can be and are used interchangeably most of the time.
What is the difference between rhinoplasty and septoplasty?
Rhinoplasty is the surgical procedure to reshape the nose, while septoplasty is the surgery to correct a deviated septum. The two can be performed together in a septorhinoplasty.
Can rhinoplasty improve breathing?
Yes, but only when performed to correct a structural obstruction in the nose. If a rhinoplasty is performed solely for cosmetic purposes, then improvement in breathing is not guaranteed.
Is tip rhinoplasty a full nose job?
No. While it is called a tip rhinoplasty, the whole nose must again be thought about for balance.
Is non-surgical rhinoplasty the same as rhinoplasty surgery?
No. Fillers and other injectables can be used for non-surgical rhinoplasty, but no structural changes will happen as in surgical rhinoplasty.
Final Thoughts
The first step in understanding the types of rhinoplasty is establishing the terminology.
Open and closed rhinoplasty indicate the type of surgical access. Some forms of rhinoplasty may incorporate Piezo or ultrasonic technology to assist in the finer aspects of bone work. Other forms of rhinoplasty seek to preserve nasal structures by using the preservation technique. Some forms of rhinoplasty may be more specific by addressing the nasal tip, while others may be more general in addressing the primary and revision needs of the patient.
There is also a more specific categorization system for surgery, including: male, post-traumatic, ethnic, functional, cosmetic, and reconstructive rhinoplasty.
This leads to a more appropriate question when seeking rhinoplasty surgery: “What may be the appropriate combination of rhinoplasty techniques to reach my goal based on my nasal anatomy?”