Motivation for rhinoplasty includes cultural conflicts and the fear of being stereotyped as an alien, ambivalence and identification conflicts with respect to parents, conflictual attitudes in the area of femininity and expression of feminine attractiveness, and in older patients active interpersonal stress, especially with husbands, which threatens the patient with depressive affects. In all the patients studied the preoccupation with the nose as ugly or inappropriate dates from adolescence. The authors found a minimum of overt preoperative psychopathology in these cases, but ten out of twenty-two of the cases had significant postoperative emotional reactions, three of which were of psychotic proportions. In the majority of cases the operation had a salutary effect psychologically, particularly in facilitating a healthier relationship with the mother and a greater comfort in the feminine role.