The business of rhinoplasty has undergone changes in keeping with increased competitive pressures locally, nationally, and internationally. Patient demands and progress in the field have abolished the "cookie-cutter" nose, with patients now requesting extensive discussions and predictions with computer photoimaging. The R-Factor Question and The D.O.S. Conversation are effective tools in rhinoplasty consultations. These tools provide patients with the clarity of what surgery can do for their lives and help patients overcome the fear produced by the overwhelming amount of information available. By helping our patients achieve the next level of success in their lives, we guarantee ourselves a busy practice filled with happy patients. The rhinoplasty consultation is the key to beginning this relationship of success.