This patient’s primary concerns were how round and wide her nasal tip and nostrils were. She wanted a more narrow and defined nasal tip as well as a flight lowering of her bridge. Finally, she was bothered by a retracted columella. She also had some issues with her breathing that she wanted corrected along with her cosmetic concerns. We performed an rhinoplasty with septoplasty and multiple cartilage grafts to help her nose function better as well as to achieve her aesthetic goals.