Quite often people ask about the "open" approach to rhinoplasty. This means that a small incision is placed on the skin that lies between the nostrils (columella), in order for the surgeon to gain better access to the nasal anatomy. Scaring with this incision is usually minimal. Even in African-American noses, the scar can be imperceptible. Keloids have never been described in this location, so keloid-formers need not worry about this incision.