The proportions of the so-called ideal nasal shape and the operations desig
ned to achieve this have been the subject of innumerable papers. The vast m
ajority of patients in the authors' practices desire a more refined version
of the nose and do not want the so-called nose-job look with ideal proport
ions. A total of 2930 cosmetic rhinoplasties performed over the past 20 yea
rs, based on the philosophy of refining the more unrefined features of the
nose according to the patients' wishes, have been reviewed, and almost all
of these patients were satisfied with the long-term shape of their nose, ev
en though in many cases these noses would be considered less than ideal by
some of the newer criteria.