Rhinoplasty is one of the most common cosmetic procedures. There are many different surgical methods and materials used, and the results achieved and the incidence of complications vary. The wisdom of the wise and the benevolent, in the specific clinical work in the end how to operate, sometimes difficult to grasp. This article talks about personal views on several problems often encountered in the clinic, for discussion. 1, rhinoplasty prosthesis placement level problem. Rhinoplasty according to the different planes of nasal prosthesis placement generally have subcutaneous rhinoplasty, subperiosteal rhinoplasty and nasal dorsal fascia rhinoplasty three. Because of the different levels of implant placement, the impact on the surgical effect is very big. Subcutaneous rhinoplasty has been gradually eliminated from clinical practice due to more postoperative complications. Subperiosteal and subfascial nasal augmentation is very beneficial to reduce the occurrence of complications and maintain the natural shape, and has become the main surgical method in clinical practice. However, how and which one is more effective is a topic of debate among clinical and scientific researchers for many years. A large number of practices and more and more information prove that subperiosteal rhinoplasty is completely feasible and the effect is undeniable. The prospect of promotion and application is very broad. As for the inability of some authors to complete the operation of subperiosteal stripping, there may be several aspects: (1) The shape of the stripper is not consistent with the curvature of the nasal bone, which is one of the most important reasons. (2) The specimen used was excessively old, and the tissue was denatured and inelastic, with weakened resistance to tensile force. (3) Improper dissection method. It is almost impossible to form a subperiosteal cavity by first removing the soft tissue of the nasal dorsum, revealing the periosteum, and then performing subperiosteal stripping, which is also not in accordance with the surgical procedure for healthy people. (4) The instruments used are different. Using only inappropriate instruments, such as ordinary knife and scissors, it goes without saying that it is impossible to form a subperiosteal nasal cavity on a cadaver, and it is difficult to form a subperiosteal cavity even on tubular bone. (5) The individual operator’s operating technique is unskilled. (6) Repeated trial placement of the prosthesis may also aggravate or cause periosteal tears. 2.Incision problem. There are many surgical incision methods for rhinoplasty, commonly used are nasal vestibular incision, nasal tip flying bird-shaped incision, V-Y-shaped incision, etc., each with its own advantages and disadvantages. Although the nasal vestibular incision is concealed, it is a little difficult to operate, and it is easy to cause difficulties in implant placement and deflection of the implant. The nasal end bird-shaped incision is easy to operate, but the postoperative scar is more obvious. In order to overcome the disadvantages of the above methods, we switched to the lower nasal columella incision combined with both sides of the nasal vestibule incision and achieved good clinical results. This method has the advantages of complete exposure of the incision, easy operation, accurate and rapid placement of the prosthesis. It can effectively avoid the problems of difficult and skewed prosthesis placement. If the incision at the lower end of the nasal columella is changed to V-shaped, the Y-shaped suture can also lengthen the nasal columella. This kind of incision seems to be larger, but the real exposed part is very small, and no obvious scar will be seen later, so it is worth promoting. 3, with the rapid development of science and technology, computerized cosmetic plastic imaging system has the advantages of realistic simulation, accurate measurement, consultation intuitive, etc., has played a very big role in communicating between the patient and the doctor. It shows an unprecedented vibrancy and vitality in rectifying certain diseases. However, for rhinoplasty, in addition to the above characteristics, it is difficult to say exactly how much prediction helps the outcome of the procedure. Because a theoretically very ideal prosthesis has to be manually sculpted; placed into a certain cavity with multiple layers of soft tissue coverage; there are also different degrees of tissue response to the prosthesis; plus individual differences and other issues, often the actual results achieved after surgery are not exactly the same as those predicted. Therefore, the influence of computer prediction on the actual result should not be overstated, and the key is to perfect the operation of surgery. We advocate that for those with simple saddle nose deformity, if there is no condition to purchase computerized phenomenon system, it is better to sculpt the prosthesis according to the patient’s nose shape before injecting anesthesia, and check repeatedly until satisfied. 4.The choice of rhinoplasty implants. There are more materials used for rhinoplasty, the traditional common ones are cartilage, bone tissue, liquid silicone, solid silicone, hydroxyapatite particle artificial bone (HA), etc.; in recent years there are some new materials, such as: Medpor (high density porous polyethylene), expanded polytetrafluoroethylene (expanded PTFE), hyaluronic acid, etc.. Among them, autologous tissue due to the trouble of taking materials, will bring greater pain to the patient, in addition to the clinical requirements of patients or patients with prosthetic rejection less applied. Allogeneic cartilage is also less used due to displacement and so on. Liquid silicone injection rhinoplasty was more popular in the early 1980s due to simple operation, but it has been banned due to many serious complications and no good remedial measures. HA is also considered a new material for rhinoplasty that has emerged since then, with good results and stable long-term effects. However, at the same time, it is also clinically found that this method can have complications such as oversized nose, poor shape, poor shaping and unevenness. The texture of nasal root and nasal dorsum after filling is still acceptable, but the texture of nasal tip is too hard. Medpor (high-density porous polyethylene), expanded polytetrafluoroethylene (expanded PTFE), hyaluronic acid and other new materials are not widely used in clinical practice. Application time is relatively short, each has its own advantages and disadvantages, due to expensive, cost-effective is not very high (such as still have rejection, etc.), relatively difficult to operate and other reasons to promote the application of greater restrictions; and silicone rubber rhinoplasty prosthesis has been in clinical application for many years, with the progress of technology, the quality is more perfect, the price is relatively reasonable, the effect is stable, the efficacy is reliable, so it is still the mainstream of the current rhinoplasty materials.