Rhinoplasty is one of the most common facial plastic procedures performed in the Hispanic/mestizo ethnic group. Today, emphasis is placed on ethnic and cultural backgrounds, definition of facial and nasal characteristics, and a clear understanding of patients’ desires. This article highlights the different types of problems encountered in mestizo patients. It describes a graduated approach to the nose whereby support structures of the nose are strengthened by careful placement of sutures and grafts, trying to achieve greater definition and support without necessarily making the nose look bigger.