Described for the first time in the 1930s by Rethi, the external approach would not have survived without its obvious advantages. It is practiced exclusively by certain authors giving the belief of better, more reliable or more durable results. This is in contrast to those who use this technique only for particular indications. This controversy emphases the need of evaluating the theoretical advantages and disadvantages of this approach relying on research. Indeed, it is clear to everybody that whatever the approach, the results initially depend more on the clinical analysis then on the qualification of the surgeon. So, if this controversy has no reason to be, moderate indications are probably useful to be set for the guidance of young rhinoplasticians.