Closed rhinoplasty

What is closed rhinoplasty?

Closed rhinoplasty — also called endonasal rhinoplasty — is a nose operation done entirely through incisions inside the nostrils. There is no cut across the columella, the strip of skin between the nostrils, so no scar can be seen on the outside of the nose. Through these inner incisions the surgeon can reduce a hump, narrow the bones, straighten the septum and refine the tip, but sees less of the framework than in an open operation and works partly by feel.

This page explains who suits the closed approach and where it reaches its limits. For the full guide to a nose job in Turkey — trip, packages, choosing a surgeon — see rhinoplasty in Turkey; for noses that need direct access, see open rhinoplasty.

Ask a surgeon whether closed rhinoplasty suits my nose

Who is closed rhinoplasty suitable for?

The closed approach works best when the changes are clear and the framework of the nose is reasonably straight and strong. You are often a good candidate if:

• The main problem is a hump on the bridge — the most common reason for a nose job. A hump can be removed or, with preservation techniques, the bridge lowered as a whole, both usually through closed incisions.
• The tip needs moderate refinement: slightly narrowing, lifting or defining a tip that is already fairly symmetrical.
• The bones need narrowing but the nose is not markedly twisted.
• The skin is thin to medium: changes show through it without the strong structural support thick skin often needs.
• It is your first nose operation and no cartilage grafts are expected beyond small ones.
• Breathing needs a septoplasty at the back or middle of the septum — that is done through the inside of the nose anyway (septoplasty).

A surgeon can usually tell from good photos — front, both sides, both angles and from below — whether a closed plan is realistic, and confirms it at the examination in Turkey.

The limits of closed rhinoplasty

Patients sometimes choose a clinic because it promises "no scar" for every nose. A scar under the nose is small; a tip that heals asymmetric is not. These are the situations where the closed approach is usually not the right tool:

• Complex or asymmetric tips: a wide, bulbous or uneven tip that needs cartilages reshaped and stitched symmetrically is harder to control without seeing both sides together.
• Crooked noses: a deviation at the front of the septum or a twisted middle vault usually needs grafts and stitching under direct view.
• Large grafts: a strut to support the tip, extension grafts or rib cartilage are difficult to place accurately through the nostrils.
• Most revisions: after a previous operation the anatomy is scarred, and most revision rhinoplasty is done open.
• Thick skin needing strong support: common in ethnic rhinoplasty, where the tip must be built up to show through the skin.

Some surgeons perform even demanding cases closed, and that can work in very experienced hands. But if a surgeon who mainly operates closed is offered a nose that clearly needs open work, ask why — and whether they can show results on noses like yours.

Open or closed rhinoplasty? A quick check

The decision belongs to the surgeon after an examination, but this overview helps you understand the recommendation. The open rhinoplasty guide compares the two approaches in detail, including the columella scar.

Preservation rhinoplasty and the closed approach

Many closed operations today use preservation techniques. Instead of cutting the hump off and leaving an open roof that has to be closed by breaking and moving the bones, the surgeon removes a thin strip of septum under the bridge and lowers the whole bridge as one piece. The smooth upper surface of the bridge, with its natural cartilage and bone junction, is kept.

• Who it suits: a hump on a bridge that is straight from the front, in a patient who wants a natural rather than a scooped profile.
• Possible advantages: a smooth bridge with less risk of visible steps, and support of the middle of the nose that helps breathing.
• Limits: it is less suitable for a very large hump, a crooked bridge or a wide middle vault, and a small hump can return in some patients and need a minor correction.

Not every surgeon performs preservation rhinoplasty, and it is not automatically better than a conventional hump reduction. Ask which technique is planned for your bridge and why, and whether the price changes.

How closed rhinoplasty is performed

Closed rhinoplasty is done under general anaesthesia in a hospital and usually takes about one and a half to three hours; most patients stay one night.

• Incisions: made inside the nostrils, between or along the cartilages, depending on what needs to be reached.
• Bridge: the hump is reduced with fine rasps or chisels, or the bridge is lowered in one piece in a preservation technique.
• Bones: the nasal bones are narrowed with small osteotomies — with chisels or, if the surgeon uses it, ultrasonic (piezo) instruments, which usually need wider access.
• Septum and tip: the septum is straightened if needed, and the tip cartilages are trimmed or reshaped through the nostrils, sometimes delivered out of the nostril to be worked on.
• Closure: dissolving stitches inside the nose, soft splints or light packing if needed and a splint on the outside.

Send my photos for a free closed rhinoplasty plan

Closed rhinoplasty cost: Turkey vs the UK

Turkish hospitals usually price a nose job by the complexity of the plan, not by the approach, so closed rhinoplasty is within the normal rhinoplasty range — from €2,890 at the hospitals on our site. Each hospital's live price is shown on the rhinoplasty page. Simple closed operations tend to sit at the lower end because they are shorter.

The figures outside Turkey are approximate private-sector totals. Patients who search for closed rhinoplasty in the UK or in London often compare them with a package in Turkey that includes the hospital night, tests, the splint, transfers and an interpreter. A septoplasty for breathing, preservation or ultrasonic techniques and extra hotel nights can add to the price; ask for every item in writing.

Ask for my closed rhinoplasty price

Recovery after closed rhinoplasty

Recovery follows the timeline described in the main rhinoplasty guide. Points typical of the closed approach:

• Week 1: swelling and bruising around the eyes, mostly from the bone work rather than the incisions. The outer splint comes off around day 7, after which you can usually fly home.
• Weeks 2–6: most people go back to work after about two weeks. No stitches have to be removed from the outside, and there is no external wound to care for.
• Months 2–12: because the skin of the tip was not lifted, tip swelling often settles somewhat sooner than after open surgery, though thick skin still takes many months.

The same rules apply as for any nose job: no nose-blowing, no glasses resting on the bridge and no contact sport until your surgeon allows it.

Closed rhinoplasty before and after: what to look for

Before-and-after photos are the best evidence that a surgeon can deliver a closed plan on a nose like yours. Look for:

• Several cases with a starting point like yours — the same kind of hump, tip and skin.
• Photos from the front, both profiles, at an angle and from below, in the same light, at least six to twelve months after surgery.
• A straight line from the front, a smooth bridge without a step and a tip that matches the bridge in profile.
• Natural nostrils from below — no pinching or collapse.

Be careful with photos taken a few weeks after surgery, retouched images or only one flattering angle. The before-and-after photos and the surgeons on this page come from our partner hospitals; you can also browse plastic surgeons and hospitals for plastic surgery.

Risks of closed rhinoplasty

The main risks are the same as for any rhinoplasty, as listed by the UK's NHS and the American Society of Plastic Surgeons: bleeding, infection, breathing difficulty, asymmetry or irregularities, numbness and the risks of anaesthesia. Published studies put the revision rate after a primary rhinoplasty at roughly 5–15 in 100. Specific to the closed approach:

• Less visual control: small asymmetries of the tip are harder to judge, which is why the approach should be matched to suitable noses.
• Irregularities of the bridge may only show once the swelling has gone and can need a small correction.
• No external scar — unless the nostrils are narrowed, which leaves small scars beside them with either approach.

A closed operation that turns out to need more work can be converted to open during surgery; ask your surgeon beforehand whether that is possible and whether it would change the price. You can read how it works before you send a request.

Get my free closed rhinoplasty quote

Hospitals with Plastic & Aesthetic Surgery in Turkey

Academic Hospital

Üsküdar, Istanbul

MoHHealth Tourism Licence+2

Get Free Quote

Lokman Hekim Istanbul Hospital

Pendik, Istanbul

JCIMoH+2

Get Free Quote

View all

Frequently asked questions