It has been said that “he who masters the tip, masters rhinoplasty”. To a large extent this is true. Creating a delicate, symmetric nasal tip that has the right projection, rotation and proportion to the other elements of the nose is a key factor in a successful rhinoplasty. It is the focal point that is initially noted and must be aesthetically pleasing for the overall appearance of the nose to look good. A great deal of experience and technical expertise is required to create a tip that is appropriate for the different skin types and anatomical variations that are encountered. Each rhinoplasty is different and, consequently, a “cookie cutter” approach is totally inappropriate. Some tips require manipulation of the cartilages already present in the area, whereas others may require either solid or crushed cartilage grafting. The cartilage necessary is usually obtained from the nasal septum or occasionally from an ear or rib. Synthetic material is not a good option, since it may extrude through the skin. Additionally, once the tip has been set, it is often necessary to adjust the surrounding tissues to produce a seamless result.