This article is aimed to elaborate the significance of detecting clinical features (subjectivity, objectivity and assessment) of the Dysmorphophobic (DMP) psychiatric patients seeking primary cosmetic rhinoplsty (PCR). DMP clients present as a fixation of their thoughts toward the trivial flaws on their body’s anatomy. They consider such minor defects as major and show a great amount of anxiety for such negligible issues. Such dread affects their social, occupational and family’s life and trigger them to seek means of correcting such small blemishes through medical and or surgical approaches. Considering to their nose, they crave to eliminate their minor defects through PCR operation. PCR is viewed as one of the most prevalent aesthetic operations in the field of cosmetic surgery. Author’s method of approach in PCR is to select candidates after obtaining a meticulous health history, physical exam and appropriate para clinical tests. In some uncertained cases, based on their subjectivity and objectivity presentations, are referred for consultation with a psychiatrist for final assessment. Most selected patients undergo PCR via standby anesthesia through an incision on the nasal columella (open rhinoplasty), or in others which their nasal tip alternation is not needed, PCR is approached with no incision on the nasal columella (closed rhinoplasty). Due to the high demand of PCR in the world, among many clients who are seeking for such surgery, might be some cases with DMP disorder who are overlooked in spite of an accurate surgeon’s screening.