Dr. Shah uses both endonasal and external approaches in revision rhinoplasty depending on what your specific needs are. Endonasal rhinoplasty is where all incisions are made within the nostril, while external rhinoplasty is where a small incision is made across the columella (skin area between the nostrils). There are pros and cons specific to each procedure. Dr. Shah feels strongly that every rhinoplasty surgeon should be able to use both techniques so that patients can have the best possible procedure for them.