Asian rhinoplasty presents unique challenges to the surgeon. The aesthetic goals should be tailored for the ethnicity and culture of the individual patient. Unlike typical Caucasian rhinoplasty, primary Asian rhinoplasty is frequently augmentation rhinoplasty. Alloplastic implants have had a long history of safety in Asia, but many patients are not suitable for or not agreeable to the use of alloplastic materials and autologous costal cartilage should be considered. This procedure is safe and reliable when these techniques are properly executed.