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Nose Re-Surgery

Closed vs open approach

I had my nasal tip done with ear cartilage and I’m considering full removal. I went for a hospital consultation, and they said that if the support strut was inserted using ear cartilage, it has to be removed through an open approach for safe removal. They said that with a closed approach, the alar cartilage could be damaged, and that the support strut can’t be removed through a closed approach. But my primary surgery was originally done through a closed approach, and I have keloid-prone skin, so every place that was incised this time formed scars. That’s why I want to do it through a closed approach as much as possible. What should I do? I really don’t want a scar on the columella. Please give me some advice

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