I have a lot of young patient’s who bring me pictures of the “Kim Kardashian nose job” during their pre-operative visit at my Los Angeles office. What I’m impressed with beyond her natural beauty, is that these young patients could even recognize Kim Kardashian’s plastic surgery. It is a subtle change, but does all the wonderful things that finesse rhinoplasty can do. Kim Kardashian’s plastic surgeon must have know that s/he was messing with near perfection. But the human perception can be highly fickle, and anything that distracts from the beautiful symmetry of someone’s eyes will undermine our attention. This is a subconscious phenomenon that is with us from an early age. Many of my rhinoplasty patients are very articulate about these subtleties.Here’s what I notice about Kim Kardashian’s plastic surgery from a rhinoplasty surgeon’s point of view. I see a visual line that extends around the eyebrow to the nasal tip. This is the line that forms a frame around the eye on each side. We want it to be a clean concave line. In the before picture, this line starts out flattened at the brow, then turns concave, and then turns convex toward the tip, giving it a “pear” shape. Her nasal tip is relatively large though reasonably sized given her prominent eyes. Her nasal tip is under-rotated, pointing down especially when she smiles. The post-operative picture shows clean, symmetrical concave visual lines surrounding the eyes. The contour of her lower/tip cartilages have been reduced and refined. Kim Kardashian’s nasal tip has been rotated up in a way that reveals the underside of her delicate nostrils and shortens her nose to a length similar to that of her brow if it were turned 90-degrees on its side.