A 20 yo woman who does not like her nasal profile. She also has severe nasal obstruction and before her surgery would snore at night and wake up with a dry mouth in the morning. She had a positive Cottle maneuver bilaterally which is a test for collapse of the nose at the internal nasal valve. She also has significant deviation of the septum. She is shown before and again, 1 year after an open aesthetic rhinoplasty combined with a septoplasty and bilateral spreader graft placement. Her nasal obstruction has resolved. She is thrilled with her new nose and no longer tries to hide her profile. The nasal tip should continue to gain in refinement over the next 2 years as the swelling in the nasal tip continues to decrease.