Rhinoplasty is still one of the most performed aesthetic surgical procedures. Over the past 20 years, the trend has shifted from ablative techniques involving reducing or dividing the osseo-cartilaginous framework to conserving native anatomy with cartilage-sparing suture techniques and augmentation of deficient areas correct contour deformities and restore structural support. The foundation for a successful experience for both patient and surgeon involves accurate preoperative analysis and clinical diagnosis, identification of both the patient’s expectations and the surgeon’s goals, and a thorough review of the plan of care and expected postoperative recovery. Rhinoplasty remains one of the most challenging procedures in cosmetic surgery. I can achieve excellent surgical outcomes only through a thorough understanding of the multiple nasal anatomical variants and a comprehensive knowledge of the ultimate long-term effects of various surgical techniques on the overall appearance and function of the nose. I should practice a philosophy of balance, preservation, and restoration of tissues (rather than a purely deductive approach, which can introduce tissue spaces and uncontrolled scarring of tissues).