Rhinoplasty operations were first performed in Europe in the 19th century, and since that time there has been much controversy on the best approach. Currently, the majority of rhinoplasty operations are performed using the “open access” approach. This approach has helped many surgeons get started in functional aesthetic surgery. However, the disadvantages of the open technique, such as destabilization of structures, longer operating times, and prolonged wound healing, allowed a comeback of the closed technique. In order not to lose the advantage of a better overview in the open technique, some steps of the operation may also be performed under endoscopic control. For this purpose, new instruments and an optical Aufricht were developed. Visual inspection of individual steps of the operation, as well as specialized miniaturized instruments, allow operations to be performed using minimally invasive technology, leading to good results and fulfilling the desire of many patients.