This is a 19-year-old female who underwent septo/rhinoplasty. She presents with breathing difficulties and would like to improve the appearance of the nose. On examination she has a prominent dorsal hump and bulbous tip. An open septorhinoplasty was performed including osteotomies, dorsal hump reduction spreader grafts and tip refining sutures. Images are before and 4 weeks post op. We can expect further improvement after swelling comes down over the next several months.