Identify specific concerns with appearance of nose.

Difficulty with breathing or history of snoring.

Prior nasal surgeries or smoking history.

Motivating factors: Personal (internal) desire or external pressure.

Evaluate patient in front of a mirror.

Identify skin type, skin thickness, symmetry, and balance of facial aesthetic units.

Describe external nose by assessing frontal view, lateral view, and base view.

Frontal view: Allows assessment of balance, symmetry, shape, and tip contour, including the following: nasal bones and width, dorsal aesthetic lines, nasal deviation, contour irregularities, upper and lower lateral cartilage irregularities, alar width

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  Tip assessment: Evaluate bulbosity, tip-defining points, alar shape, nostril size and shape.

Lateral view: Allows assessment of nasal length, dorsum, tip, projection, rotation, alar–columellar relationship, radix height, frontonasal angle, chin projection, and anthropomorphic landmarks

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  Critical angles are the nasolabial angle (90 to 100 degrees in women, 90 degrees in men) and frontonasal angle (115 to 130 degrees).

  
  
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  Hypoplastic/retruded chin: May affect overall balance of face. Can consider concurrent genioplasty.

Base view: Allows assessment of nostril shape and size, columellar width, alar base width, length of medial crura, curvature of lateral crura, alar lobule thickness, septal position

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  Ideal base view is an isosceles triangle in which the upper third is tip lobule and lower two-thirds is columella/nare.

Internal examination: Includes evaluation of the nasal septum, internal and external nasal valves, turbinates, and lining

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  Cottle maneuver and examination with vasoconstriction should be performed to assess for airflow.