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A critical step in successful surgery is the precise definition of the surgical goals by both the patient and the surgeon. Much of the discussion between the surgeon and the patient is about managing expectations. Today’s technology provides an easy way of forecasting the result of a rhinoplasty procedure, as long as surgeons themselves do the morphing. In a retrospective study of 133 rhinoplasty patients, we analysed the correlation between pre-operative morphing and surgical results. The match was good (identical or similar) in 85.7% of patients (n = 114), approximate in 11.3% of patients (n = 15), and poor in 3% (n = 4). There was a significant correlation with an increased need for adjunctive procedures or revision surgery when the match was approximate or poor. The approach also proved useful for careful pre-operative planning by the surgeon, requiring detailed facial analysis and the establishment of precise goals before surgery. Overly optimistic morphing is not recommended given the risk of raising false expectations.