Rhinoplasty is performed by separating the skin and mucosa from the skeletal framework (bone & cartilage) and then rearranging or resizing the skeletal framework. Then the skin and mucosa is allowed to redrape over the new shape. An open rhinoplasty is performed by flipping the skin upward like the hood of a car so the surgeon can directly see what is being worked on. A closed approach has much less visibility and is done more by feel. Closed rhinoplasties are usually reserved for very simple, straightforward hump reductions.