The limitation to rhinoplasty is due primarily to the artistic skill required to obtain results; secondly, to the risks involved by loss of tissue due to gangrene, imperfect healing or accidental interference, post-operatio; and thirdly, to scarring about the face as a result of the primary and secondary wounds; in fact, so much so that many surgeons prefer to allow a small defect to remain, to escape the risks involved in correcting them. The author believes such fear misplaced, because with the methods of surgery of the present day and the proper knowledge of the art there need be little risk involved and the result expected should be as near perfect as human skill can make it. True, a surgeon cannot be expected to build an entire nose from the skin or other tissue of the forehead or cheeks and make it a thing of aforethought beauty and shape, but if the result be no more than a curtain of skin to hide the hideous deformity he has done his share, and such result is the worst he might look forward to. For the correction of nasal deformities the author will consider first such operations as involve the entire loss of the nasal organ or _total rhinoplasty_; thereafter _partial loss_ of the nose, and lastly such cases involving no loss of tissue and dependent on malformation only under _cosmetic rhinoplasty_. It is not here intended to lay down a law for the surgeon for the restoration of the entire or part of the nose for the reason that each case differs more or less; that in each case there is more or less tissue that may be utilized, and that there are many methods advanced for such procedure, but the author does desire to give to the operator a concise and comprehensive treatise on rhinoplasty and to illustrate the best of such operations as have been placed on record as a ready guide and for immediate reference—a matter of no small moment when this literature can be gained only by searching through innumerable medical journals and short references and in all languages of the civilized world. In the chapter on history some idea of the time in which rhinoplasty has been practiced may be obtained. It is not deemed necessary to go into further historical facts here, except, perhaps, to divide the subject into the three most important schools or countries that have given individuality to the art. THE CAUSES OF NASAL DESTRUCTION The loss of the entire nose may be due to traumatism, actual amputation, the bites of man or beast, duels, the removal of neoplasms, gangrene after freezing or disease, rhinosclerosis, syphilis, the application of caustics, tubercular disease, lupus, cancer, and rarely congenital absence of the organ. The loss may be total or partial. The extent of loss of substance in each case differs, and it is for this reason that surgeons have been compelled to originate many methods of operation, each having for its object to correct the deformity as neatly and as near to the normal as possible.