There are mainly endonasal and external approaches in rhinoplasty. The incisions are classified as alar cartilage, septal, and transcolumellar. In this chapter, the pros and cons of these two approaches and different incisions are discussed. All the incisions presented here have a certain value depending on the individual situation of the patient and the experience of the surgeon. Marginal incisions have gained more popularity in recent years compared to intercartilaginous and transcartilaginous incisions as alar cartilage incisions. Although the hemitransfixion incision was the gold standard method for approaching the nasal septum, the use of septal extension grafts and tongue-in-groove has been popularized among structural rhinoplasty surgeons. Approaching the septum after dividing the soft tissues between the medial crura has also become a favorable approach. External rhinoplasty incisions are still very widely accepted, although there is a revival of endonasal incisions worldwide.