When performing rhinoplasty on African American patients, do you more commonly use an open or closed approach and why?

It depends. If a patient requests refinement of the nasal tip, I typically recommend an external, or open, approach. Through this approach, I have the exposure necessary for me to perform the maneuvers to achieve reliable, long lasting results to the nasal tip. If the patient requests refinement of the nasal bridge only, I may recommend an endonasal, or closed, approach.