**4. Structural assessment**

Structurally the nose is formed from cartilage, bone, muscle, connective tissue and skin. It is clear that the quantity and quality of these components play a determining role in the outcome of aesthetic nasal surgery. For structural evaluation, the nose is gently palpated by the surgeon. The quality and thickness of the overlying skin is size and length of the bony vault is grossly measured and then subtle finger pressure is applied over the tip to determine the strength and support of the cartilage framework. Then, the patient is asked to smile. Excessive drooping of the nose or unpleasant widening may be an indicator of muscular hyperactivity or structural weakness that both may be easily corrected with a thorough treatment plan.
