The aim of the present work is to make a contribution in resolving the controversy between the traditional and "open" approaches to rhinoseptoplasty. Over these last few years, particularly in the United States, the Rethi technique (1920) has encountered unceasing opposition among those using the "open" approach and those who, on the other hand, assert that they can achieve equivalent results without resorting to the supplementary columellar incision. Since 1989 we have been using the technique proposed by J.B. Tebbetts in 1987 and published in detail in the July, 1994 issue of "Plastic and Reconstructive Surgery". The authors feel that Force Vector Tip Rhinoplasty has been the only true innovation since Joseph (1931). Moreover, because of its content, this technique has exceeded the general term of open rhinoplasty. Indeed, this term is extremely general and simply indicates what surgical route is used. Nevertheless, the access route alone does not justify the choice of technique. On the other hand, what is truly innovative is the particular philosophy and technical aspects of Vector Rhinoplasty. In fact, by adding particular suture points and cartilaginous graft along calculated, extremely precise force lines, it is possible to modify the nasal skeleton. This is achieved with a steady, direct control and without damaging the delicate structures being supported. The term "Optimized Force Vector Tip Rhinoplasty" clearly depicts the concept, not only of a more complex access route; it also underlines the advantages in terms of intraoperative diagnostics, precision in performance and stability in time.