During a closed rhinoplasty all of the incisions are in the inside of the nose and during an open rhinoplasty there is one additional incision made on the columella which is the skin separating the 2 nostrils. This very small incision if placed properly and closed properly should be nearly imperceptible. Please be aware that if nostril reduction is necessary those incisions are independent of either closed or open rhinoplasty technique and those scars may be more visible. There are some great surgeons that do every rhinoplasty through an open approach and there are some great surgeons that do every rhinoplasty through a closed approach. But there are also plenty of lousy surgeons that do open or closed rhinoplasty. What is important is the actual surgeon. I would much rather choose a closed rhinoplasty that was done well to an open rhinoplasty that was done poorly and vice versa. Personally I do both approaches and I tailor each surgery to each patient’s nose and needs. While closed rhinoplasty usually creates less swelling and quicker healing at the tip many patients do require open rhinoplasty for better more structural tip work. But there are also plenty of lousy surgeons that do open or closed rhinoplasty. What is important is the actual surgeon. I would much rather choose a closed rhinoplasty that was done well to an open rhinoplasty that was done poorly and vice versa. Personally, I do both approaches and I tailor each surgery to each patient’s nose and needs. While closed rhinoplasty usually creates less swelling and quicker healing at the tip many patients do require open rhinoplasty for better more structural tip work.