This chapter discusses asian rhinoplasty, which constitutes an entirely different surgical endeavor from Western aesthetic rhinoplasty. The nasal dorsum tends to be shallower and less well-defined, a characteristic that can be exacerbated by a broad epicanthal fold of the eye. The overlying skin envelope is generally much thicker than is evident in most Caucasian noses. The premaxillary component tends to be deficient which leads to a more simianappearing, acute nasolabial angle. A precise surgical method and particular type and configuration of silicone must be used to achieve the optimal aesthetic result and to ensure maximal safety. A surgical marking pen is used to mark the nasal bone-upper lateral cartilage junction as well as the midline. The bony nasal dorsum should be directly infiltrated transcutaneously in order to hydrodissect the periosteum of the underlying nasal bone. Alar-base reduction can complement and balance augmentation rhinoplasty using a silicone implant.