Rhinoplasty describes an array of operative techniques that can be used to alter the aesthetic and functional properties of the nose. Surgical access to the nose can be gained via incisions placed inside the nose (endonasal approaches) or via incisions placed inside the nose combined with incisions placed outside the nostrils (external approach), usually on the columella. Prior to the increased popularity of the external (open) rhinoplasty approach in the last decade, the terms rhinoplasty and endonasal rhinoplasty were almost synonymous. This somewhat artificial division between external (open) and endonasal (closed) rhinoplasty has become an established part of current rhinoplasty nomenclature. Despite this, both approaches share many of the same incisions, and many of the same principles apply regardless of the approach chosen.