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Dr. Mark Oyama M.D., director of plastics surgery department at Dling Medical Aesthetic Center, has his own philosophy resulting from 25 years surgical experience focusing on Asian patients: Rhinoplasty surgical techniques are as varied as the different types of ethnicities that seek it.   Asians in general want to have the nose enhanced, augmented, and projected. Everybody else in general have large noses, large humps that they want reduced. Regardless of whether the nose is to be enhanced or reduced, the aesthetic end point should be the same: The result should look natural. A pleasing profile which starts at the level of the upper eyelid, straight or slightly concave. Symmetry and definition of the nose and tip. Smooth anatomic transitions without irregularities, edges, or scars. The tip should be the highest point of the nose, and slightly rotated at 100 or 110 degrees. Breathing should not be compromised In the event a nasal implant is used, the result should be long lasting, resist infection, and not compromise the soft tissues of the nose.  Over the years, I have developed a practical, no-nonsense approach to rhinoplasty. I use a variety of techniques, a variety of grafts, (silicone, gortex, ear cartilage, septal cartilage, and combinations of them) I do not believe rhinoplasty should be exhorbitantly priced either. Come on, how much can you possibly do in that little space of real estate?