There are two basic methods for performing cosmetic nose surgery, the open method and the closed method. At our Bethesda, Maryland rhinoplasty center, Dr. Jennifer Parker Porter has extensive experience with both methods. During an open rhinoplasty procedure, your surgeon will make a small incision along the columella. The columella is the strip of tissue that separates the nostrils. An open rhinoplasty tends to leave a tiny scar, but the scar is hardly visible because it is strategically placed in an area that is usually in shadow. If a closed rhinoplasty procedure is performed, then the sites of the incision will all be internal rather than external. Our surgeons prefer to use the closed technique for the majority of their procedures, reserving the open technique for patients undergoing revision rhinoplasty, patients increasing their tip definition, or patients correcting an overall structural problem such as a crooked nose. The closed rhinoplasty procedure works best for patients with thin to medium skin thickness, while the open procedure is often the more suitable option for patients with increased skin thickness. There are benefits associated with both methods, and a comprehensive consultation is the only way to be certain about which method would be most appropriate for your specific rhinoplasty needs.