Most patients seeking rhinoplasty desire enhancements of their nasal profiles. In fact, more than 80 % of all rhinoplasty patients are seeking a reduction rhinoplasty because they feel their nasal profiles are too prominent. However, it is first necessary to determine why the patient feels this way, since there are many different causes of the overly prominent nose. Proper characterization is critical, since failure to correctly analyze the cosmetic deformity may lead to inappropriate treatment and patient dissatisfaction. Is the problem a simple overprojected dorsal hump? Or is the entire nasal profile, including the nasal tip, overprojected (i.e., rhinomegaly)? Alternatively, does the excessive prominence result from a tension-nose deformity in which an overprojected dorsal septum gives rise to pinching of the middle vault and excessive elongation of the nostrils (Fig. 5.1)?