Dr. Peter C. Kang's surgical technique for complex revision rhinoplasty using a closed approach

I am Dr. Peter C. Kang, medical director of NOSELAB Clinic and the NOSELAB Rhinoplasty Research Center.

Many patients consistently ask about the incision methods used in closed rhinoplasty and whether it can also be performed for revision cases. I felt it would be helpful to organize these details and discuss closed rhinoplasty today.

First, rhinoplasty can be viewed from both aesthetic and functional aspects. Beyond primary surgeries, many patients also visit us for multiple revision procedures after experiencing contracture and inflammation.

At our clinic, we perform all rhinoplasty procedures, including primary surgeries and revisions, using a closed approach.

Unlike standard open rhinoplasty, this surgical method does not cut across the columella. Instead, incisions are placed entirely inside both nostrils where they are not visible. This technique leaves no external scar, supports a faster recovery, and aims to minimize complications.

Differences between closed and open rhinoplasty incisions

Have you noticed the difference between closed and open incisions?

Standard closed rhinoplasty is typically selected when performing a simple, minor nasal procedure through minimal intranasal incisions. However, while the closed rhinoplasty I perform shares the same name, the surgical scope is entirely different. You can think of our closed rhinoplasty as encompassing the same comprehensive surgical maneuvers as open rhinoplasty. As such, it is a technique that cannot be performed without extensive surgical experience and in-depth anatomical knowledge of the nose.

Let us examine why we perform closed rhinoplasty despite its technical difficulty.

Explanation of the columellar artery

We have explored the incision techniques and benefits of closed rhinoplasty.

Columellar shape and scarring after closed rhinoplasty

Columellar shape and scarring after open rhinoplasty

Please examine the photos to see the clear difference.

Has this answered your questions regarding incisions in closed rhinoplasty?

The reason I adhere to closed rhinoplasty is not solely about scarring. My interest in the closed approach began with considering how to operate while minimizing disruption to normal structures as much as possible, and how to shorten recovery time.

Because recovery from any surgery is closely linked to blood circulation, my goal to minimize vascular damage led me to adhere to the closed approach.

By preserving the columellar artery and vein—which might otherwise seem minor—and avoiding excessive damage to surrounding blood vessels typically caused while securing visual exposure in open surgery, I believed less scar tissue would form and the risk of inflammation could be reduced. Having performed closed rhinoplasty for over 10 years, I have seen this reasoning confirmed in practice.

Performing all revision surgeries through a closed approach is not an easy commitment to make, but I continue this effort with the conviction that closed surgery helps minimize complications.

Patients occasionally ask whether it is truly feasible to perform revisions using a closed approach. While I cannot promise uniform outcomes to everyone, I dedicate my utmost effort to each procedure to deliver the intended result.

Thank you for your ongoing interest and inquiries regarding Dr. Peter C. Kang's closed rhinoplasty.

If you have any questions, please feel free to reach out, and we will be happy to assist you. For detailed consultations and surgical planning, please search for NOSELAB and visit our clinic.

This was Dr. Peter C. Kang, medical director of NOSELAB Clinic and the NOSELAB Rhinoplasty Research Center.