Rhinoplasty in the aging patient presents a unique challenge to the facial plastic surgeon. The effects of age on the skin, ligaments, and cartilage of the nose conspire with the relentless pull of gravity to create a ptotic tip and collapsing nasal sidewalls. Combined with the increased incidence of other comorbidities in the aged patient, the resulting functional and cosmetic problems that ensue can be difficult to overcome. The astute plastic surgeon, however, will not vary from a systemic and patient-centered approach to each individual problem. Moreover, armed with common tools such as cartilage grafting, tip-suturing techniques, and meticulous handling of fragile tissues, the surgeon can restore the nose to a more youthful appearance and functional state. Although once taboo, rhinoplasty in the aging patient is increasingly a rewarding procedure for both patient and surgeon alike.