Nasal size and shape can be modified by the removal of tissue, the addition of grafts, the rearrangement of cartilage and skin, and the careful placement of internal sutures. Individual goals are developed based on patient desires, anatomy, ethnicity, and gender. Some methods use only inside hidden incisions and others may require small incisions on the skin. Airway and breathing problems can be addressed, if necessary, during this surgery. A natural, harmonious look is Dr. Terrasse’s goal.