Purpose: The main goal of this article is to review the literature of general health and nasal anatomical-physiological profile of the elderly, prior to considering them as a candidate for primary cosmetic rhinoplasty (PCR). Rhinoplasty is the cosmetic nose’s surgical alteration. Materials and Methods: We extracted the information from internet search engines and the End Note software version X7. Criteria were applied to the most appropriate clinical messages related to the elderly. We focused on their general health status and their nasal anatomicalphysiological considerations prior to consider them for undergoing PCR. Research links were mostly from the Pub Med and the Medline databases. Results: the literature review showed that as people age, their health status and anatomical-physiological components of their nose alter. Their nasal anatomical supports get weaker, and their nasal internal and external physiology undergoes modifications. Functions related to the nasal supports, normal physiology of smell, airway passage, humidification mechanism and their general appearances are affected by age. Conclusion: Cosmetic surgeons must be aware of the aforementioned changes of the patients’ past and present health. Considering performing a complete systemic evaluation and the nasal anatomical-physical examination to assess the degrees of alterations, are crucial pre-operatively.