We can perform rhinoplasty through either an open or closed (endonasal) approach. In our practice, we perform almost all surgeries through the open technique. An open approach combines the use of incisions inside the nostrils with an additional small incision that hides in the columella (the skin between the nostril openings). The advantage of the open technique is that it provides a better view of the underlying nasal structure with the ability to re-contour the nose more precisely. The scar in the columella typically fades well over time and becomes difficult to see.