There may be no field in which outcome is more obvious than in cosmetic nasal surgery. Both the quality of the procedure and the cosmetic quality of the result play an outstanding role in the arena of cosmetics. The expectations and interests of the surgeon are not always the same as those of the patient. Furthermore, with combination surgery, cost bearers focus independently on quality. This is often wrongly confused with economy. Objective criteria play a crucial role for the physician, but soft criteria are very important for patients. This is much more difficult, as everyone knows that beauty is in the eye of the beholder and must be compatible with functions such as breathing and smelling. There are many different quality standards, so that it is difficult for the patient to choose the right physician, particularly if he has to bear in mind the countless seals and certificates, and the influence of the internet and social media. But even the surgeon has to sift through a large number of congresses, courses, and symposia, if he is to achieve a minimum level of quality. Even though rhinosurgical techniques have greatly improved in recent decades, the patient always regards the quality of the outcome as being more important than the quality of the process. This paper presents a status report on the most objective quality indicators for cosmetic nasal surgery, as seen through the eyes of physicians, patients, and cost bearers, and in the context of changing surgical techniques.