A rhinoplasty is a commonly performed procedure and once again, natural results are very important. I do not believe in over-resecting noses or throwing away of a lot of the cartilaginous structure and support. I support the noses so that the long term results will last. Rhinoplasties can be performed either through the open or closed approach. The closed approach I preserve mainly for adjusting the hump of the nose. I prefer to use the open rhinoplasty when adjusting the hump as well as the nasal tip and the cartilages related to the tip of the nose. Breathing problems are often addressed at the same time with a septoplasty and/or inferior turbinate reduction by means of an endoscope. Crooked noses are also addressed at the same time. I often encourage people to bring pictures of noses that they like, stressing the point that this gives an idea of the features that one would like and doesn't mean that the person will be getting that nose. I do not like computer imaging because I do not believe that one can predict the result to that degree and can give the patient a false impression. .