Open tip rhinoplasty also known as external approach or open structure rhinoplasty has gained much popularity in the past three decades among rhinoplasty surgeons due to some main features of this technique such as direct visualization of the anatomy and precise diagnosis of the deformities bimanual control of the structures and possibility . Open structure rhinoplasty osr uses the open or external approach via a mid columellar and bilateral marginal incision in combination with grafting procedures such as columellar struts dorsal grafts and tip grafts rhinoplasty has developed from a merely reductive procedure to a more graduated approach to the nose. In open rhinoplasty the nasal skin is lifted during the operation and the surgeon has good control over and access to the nasal structure whereas the skin is not lifted in closed rhinoplasty hence the limited visibility and maneuverability open rhinoplasty is the preferred method for patients who need extensive modification to their nose
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