Rhinoplasty is often regarded as perhaps the most intricate and challenging of all surgeries. It requires the mastery of surgical technique combined with the artistry of an aesthetic sculptor. Most importantly an ideal outcome depends on the relationship between the patient and surgeon. This relationship must be based on trust and understanding. The patient must trust the surgeons’ aesthetic judgement, the surgeon must in turn listen to and understand the patients’ aesthetic goals. When these factors are in harmony a successful outcome is virtually assured.