“Closed rhinoplasty” is a technique that does not involve external incisions and does not deglove the nose from its underlying framework. Alpine-style mountain climbing is often a swift, and difficult solo endevour. Closed rhinoplasty is similar in that it is difficult to learn, perform, and teach. But for surgeons who are facile with the approach, and for the selected nose, the closed approach can offer less swelling, bruising, and down-time. All without the external scar required with the open approach. It leaves all of the scars within the nose and does not require the use of nasal packing. It is not for all noses. Oftentimes an open approach is best suited for noses where a large amount of tip-work is needed or in difficult revision cases.
I decided to come to Louisville for Plastic Surgery training, largely to learn the art of closed rhinoplasty from one of the masters. I decided to stay because both rhinoplasty and Louisville are very special to me.