Improving the cosmetic appearance of the nose by diminishing the dorsal hump and refining its shape, yet having the result look natural, is a frequent request from patients seeking a rhinoplasty. Following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on 2 dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the operative procedure would not be in your best interest. I would suggest you find a plastic surgeon with extensive nasal surgery experience who is certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or the Canadian Society for Aesthetic Plastic Surgery (CSAPS) or a facial plastic surgeon that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.There are many variables that contribute to surgical fees: the extent of the procedure, geographic location of the surgical practice, the credentials and level of training of the surgeon, his or her expertise and reputation, the fee for the anesthesia provider, and facility charge (the facility should be accredited by a national accrediting organization like the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)). It is important to compare “apples to apples”. You should find the most qualified individual to perform a surgical procedure, not the least expensive. Your health and safety depend on it. If your selection of a surgeon is determined primarily by high or low fees, ultimately, you may be disappointed with your choice. Shopping for bargains should be saved for sandals and t-shirts not procedures that require scientific knowledge, training, judgment, artistry and expertise. Robert Singer, MD FACS La Jolla, California