I recently returned home from Dubai where I saw mostly Arab patients who wanted to have rhinoplasty and revision rhinoplasty. I saw many patients who had very distorted noses from previous rhinoplasty procedures in the Middle East. I did a lot of revision rhinoplasty on this trip and they were very difficult procedures but I am very pleased and proud of the results that I was able to achieve. The common theme among the patients who had bad rhinoplasty was the loss of support to the tip and the destruction of the structure of the bridge. The typical Middle Eastern or Arab nose has fairly strong tip support and good structure to the bridge and I needed to reconstruct these support mechanisms to recreate attractive appearing noses. Furthermore, the primary rhinoplasty that I did also had similar characteristics in that I reshaped the tips and the bridge without violating the support mechanisms. This will ensure that not only will the patients have outstanding and natural results but they will be permanent without the risk of collapse or distortion in the future. I am very fortunate to have had the experience that I have had and now I have an excellent understanding of the Arab or Middle Eastern anatomy and cultural dynamics that need to be understood to ensure that patients are more than happy with their results.