Reply to: “Invited Discussion on: Video Assisted Septo-Rhinoplasty, the Future of Endonasal Rhinoplasty–a Technical Note”

We respond to Gryskiewic and Alameddine’s commentary on our recent study regarding endoscopic use in rhinoplasty. Highlighting the context-dependent nature of technique superiority, we discuss the alternative approach of Video Assisted Rhinoseptoplasty (VARS) in mitigating visible scarring concerns. Additionally, we emphasize the benefits of comparing closed procedures with and without endoscopic assistance, underscoring the advantages of optical utilization. Our perspective on nasal tip surgery advocates for enlarged marginal incisions to facilitate direct visual control, complementing our approach. Addressing concerns on the learning curve, we share insights from our training experience, stressing the feasibility of achieving proficiency with practice. Lastly, we acknowledge the need for surgical flexibility, particularly in cases of cartilaginous weakness, where alternative strategies like spreader grafts may be considered. Our response contributes to advancing rhinoplasty techniques, promoting context-driven approaches and adaptability for optimized outcomes. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .