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Is There Scarring After Rhinoplasty? Open vs Closed Technique

May 18, 2018
3 min read

Updated: Oct 3

"Will I have a scar?" is one of the first questions patients ask about rhinoplasty. The honest answer depends on the technique. Closed rhinoplasty leaves no external scar at all; open rhinoplasty leaves a small scar on the columella, the strip of skin between the nostrils, which usually fades well. This guide explains both approaches, what determines scar quality and how to care for the skin after surgery.

Key takeaways

  • Closed rhinoplasty: all incisions are inside the nostrils; there is no visible scar.

  • Open rhinoplasty: a small incision across the columella leaves a fine scar that typically fades to a faint line.

  • Alar base reduction adds tiny scars in the nostril creases.

  • Sun protection and proper wound care improve any scar.

Is There Scarring After Rhinoplasty? Open vs Closed Technique

Closed rhinoplasty: no external scar

In the closed (endonasal) technique, every incision is placed inside the nostrils. The skin of the nose is never cut from the outside, so there is nothing visible afterwards. Prof. Dr. Suleyman Tas performs most primary rhinoplasties with the closed atraumatic technique, which also preserves blood supply and soft tissue, reduces bruising and speeds recovery. Hump reduction, bone repositioning, tip refinement and septal correction can all be done this way.

Open rhinoplasty: the columella scar

The open technique adds a small incision across the columella so that the skin can be lifted for direct visibility. This leaves a scar about 4 to 6 millimetres long on the underside of the nose. In most patients it fades to a barely visible line within a year, but it can remain more noticeable in dark or thick skin or if it heals with pigmentation. Open rhinoplasty is still the better choice for some complex revisions and major reconstructions, so the scar is a reasonable trade-off in those cases.

Other possible scars

  • Alar base (nostril) reduction: small incisions in the crease where the nostril meets the cheek; they hide well but require careful placement.

  • Cartilage harvest: if ear or rib cartilage is needed for a revision, a hidden scar behind the ear or a short scar in the chest fold results.

  • Previous surgery: existing scars are respected and, where possible, revised.

What affects how a scar heals

Scar quality depends on skin type, genetics, tension on the wound, infection and sun exposure. Smokers heal worse. Keeping the incision clean, avoiding sun for the first months, using the creams or silicone products recommended by your surgeon and not picking at crusts all help.

Does the season matter?

With closed rhinoplasty there is no external wound, so surgery can be performed in any season, including summer. With open rhinoplasty, strict sun protection of the columella scar is advised during the first months, but summer surgery is still possible with care.

rhinoplasty before and after hump treatment
Does the season matter? – Is There Scarring After Rhinoplasty? Open vs Closed Technique
Does the season matter? – Is There Scarring After Rhinoplasty? Open vs Closed Technique

Expert note from the book

In Rhinoplasty in Practice (CRC Press), Prof. Dr. Suleyman Tas describes the closed atraumatic technique, in which every incision stays inside the nostrils and the ligaments and blood supply of the nose are preserved. The absence of an external incision is why his primary rhinoplasty patients have no visible scar and why the swelling settles faster. Read more on the Rhinoplasty in Practice book page or see the results in the rhinoplasty before and after gallery.

Related reading

Read about smoking and rhinoplasty, the rhinoplasty recovery timeline and the revision rhinoplasty guide, or visit the rhinoplasty page for the full overview of the operation in Istanbul.

Frequently asked questions

Will anyone be able to tell I had a nose job?

With closed rhinoplasty, there is no scar to see. The only visible change is the improved shape of the nose.

How long does a columella scar take to fade?

Most scars fade substantially in 6 to 12 months and continue to improve afterwards.

Can a bad rhinoplasty scar be fixed?

Yes. Scar revision, laser treatment or steroid injections can improve thick or wide scars.

Which technique is right for me?

It depends on your anatomy and whether you have had previous surgery. Prof. Dr. Suleyman Tas will explain the recommended approach at your consultation. Learn more on the rhinoplasty page or contact the clinic.

About the author

Prof. Dr. Suleyman Tas is a European Board-certified plastic, reconstructive and aesthetic surgeon based in Istanbul with over 20 years of experience, author of Rhinoplasty in Practice (CRC Press) and founder of the Closed Atraumatic Rhinoplasty Course. Read verified patient reviews or book a consultation.

This article is for general information and does not replace an individual medical consultation.

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