Surgery of the internal nasal valve

Over the past 25 years external rhinoplasty has become increasingly popular. Some rhinosurgeons recommend its use widely, even in routine cases. In our view, however, the classical endonasal approaches remain the first choice. Open rhinoplasty offers an excellent visualization and therefore facility of precise correction, but causes a larger area of wound and scarring. It should, therefore, be restricted to cases of particular difficulties. In the era of minimal invasive surgery, external rhinoplasty advocated as a standard procedure seems to be a drawback, particularly if the aesthetic problem is the leading one. Every facial plastic surgeon should master closed and external rhinoplasty to be able to decide which approach is the most suitable in each situation from the patient's point of view.