In a open rhinoplasty, whether primary or revision, I do not usually need to see but rather I can feel with my fingers the ascending process of the maxilla. However, if I really needed, I could expose in both on the inner aspect through the nose or from the outer aspect by an extended dissection and exposure.
More commonly, we can move the ascending process in either outward or inward direction by performing lateral osteotomy (small bony cut). If the process if too prominent we can soften it by rasping down the bone.
It is possible to make the bones (the ascending processes of the maxilla) wider in secondary rhinoplasty. The approach (external or open, vs. endonasal or closed) is not important. The procedures requires outfracturing of the bones with osteotomies and/or onlay grafting to give the appearance of widening. This is not a commonly performed operation so please consult with a revision rhinoplasty specialist.