Rhinoplasty is a complex and complicated surgical procedure. Equally challenging is the assessment and proper selection of candidates for the procedure. The surgeon has a great responsibility to be diligent and insightful in the evaluation so that the patient’s expectations may be fully discussed and a fair and honest discussion of the goals and risks undertaken. Many ethical issues are associated with rhinoplasty, from marketing and advertising to inappropriate coding for insurance purposes. The ethical surgeon must be well grounded in his or her ethical convictions and appreciate what can occur when the moral compass goes awry.