In attempting to determine the suitability of an older person for cosmetic rhinoplasty, the surgeon must keep in mind not only anatomical considerations, but also, even more important, the emotional and psychological expectations of each patient. The surgeon should make every attempt preoperatively to arrive at a meeting of the minds with the patient, so that he has a thorough understanding of that patient's desires, needs, and hopes. If the surgeon believes he is able to achieve or even come close to his patient's goals by a conservative operative approach, there is no reason why a rhinoplasty should not be undertaken. However, it is the author's experience that rhinoplasty in the older patient often fails to produce a result wholly satisfactory to the patient and the physician, and it is necessary to keep this in mind when selecting patients.