The Japanese honorific "san" can be used when speaking English but is never used when referring to one’s self. Japanese place surnames before given names but often reverse the order for the benefit of Westerners.[13] A smile or laughter from a Japanese person may mean that they are feeling nervous or uncomfortable, and not necessarily happy. Tipping is rarely practiced in Japan, and can be considered as an insult, except in certain cases, such as tipping your surgeon for an operation, when visiting a high class ryokan, or when dealing with house movers.