What that means is that some surgeons will make an incision underneath the nose. It allows the surgeon to flip the skin back and to see everything they’re doing. And in fact I’d say most surgeons do that approach, most of the time.
I still do that approach when it’s indicated for asymmetries, a difficult tip, for revising other people’s problems. But when I can I’ll always try to do everything inside of the nose. It’s called an endonasal approach, where there’s no external incisions.
The advantage of this is that you have no scar. Most of time that scar is a cosmetics scar but occasionally is not and I’d always rather avoid it if I could.
The second reason is that I feel like I had better judgment during the surgery to give you a great aesthetic result because I can see better with less swelling and there’s less trauma to the tissue and as a result you’re healing better. It’s faster, you have less swelling, and so I always rather do it that way