This 22 year old requested to improve the appearance of her nose as well as her obstructed breathing. She said she has her “Dad’s nose” and asked to have it made less crooked, the hump reduced, narrow middle portion of the nose made wider, bulbous tip refined, alar retraction improved and wide alar bases narrowed. Our office performed an open rhinoplasty allowing him to reduce the patient’s bony cartilaginous hump, refine her asymmetric bulbous tip, straighten her crooked nose, widen her middle vault with spreader cartilage grafts, lower her retracted alar rims with alar contour grafts, and narrow her asymmetric wide alar bases. The patient said her recovery was quick and easy. She loves the natural, improved appearance of her nose as well as her ability to breathe well again.