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Asian rhinoplasty, and rhinoplasty performed in other ethnic groups, remains a challenging operation for plastic surgeons. Precise clinical analysis and systematic planning preoperatively are widely accepted as the keys to success. Although a variety of analytical techniques have been published for other ethnic groups, a systematic approach for Asian rhinoplasty remains underrepresented in the current literature.A systematic approach and a stepwise technique were developed concomitantly with concepts in facial balance and proper preoperative evaluation for Asian patients. A retrospective review of 110 cases in 4 years was performed to evaluate the effectiveness of this approach.Follow-up ranged from 6 to 48 months. Satisfactory results were achieved in 86 percent of cases. Typical cases were also reviewed.The systematic approach in Asian rhinoplasty presents a way to link appropriate analysis with specific techniques aimed at the subtleties of Asian rhinoplasty. This leads toward the individual’s aesthetic goals. In the authors’ experience, this approach allows for predictable and optimized results for this challenging procedure.Therapeutic, IV.