ABSTRACT
Rhinoplasty surgery can be performed using two fundamentally different approaches: the open approach and the closed (or endonasal) approach. The closed approach is the oldest method and leaves the columella skin intact. The open approach incises the columella and retracts the lobule skin cephalically, exposing most of the osteocartilagenous framework. Some surgeons predominantly use the open approach, others predominantly the closed approach, and some will use a combination of approaches depending on the exact patient characteristics.
