Firstly I think of the size of the nasal tip is it normal big or small. Then I think of the site of excess size, if present is it a vertical excess or a horizontal excess. Then to explain these two aspects further I think of the position of the lateral crus, is it malpositioned more vertically as in the perenthesis tip or is it excess horizontal width because the right and the left tip cartilages are widely spread or divergent. Thirdly I think of the shape of the tip cartilages to explain a problem with size and the site of the size problem. Are they excessively convex and if so where is the site of that convexity, which margins of the tip cartilages are involved the caudal or the cephalic margins and in which access or direction does the curl run. In summary I think of surface aesthetics in terms of size and shape of the tip and then try to see nasal anatomy to explain and anticipate the size, site and shape of the tip cartilages themselves. This careful analysis then enables me to make an individual operation plan.