An open rhinoplasty is when the nasal skin is elevated or lifted off the underlying cartilage. Usually a small incision is made in the columella (the skin separating the nostrils) to elevate the nasal skin. A closed rhinoplasty is when incisions are made in the nostrils to gain access to the nasal cartilage an bone. A closed rhinoplasty avoids an external incision in the skin between the nostrils.