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Mr. B. had worsening of a developmentally deviated nose after nasal trauma. He wanted correction that retained the essence of his pre-surgical appearance with mild narrowing of his tip. Facial asymmetry played a large role in his nasal deviation. A closed Foundation Septorhinoplasty with suture-tip plasty technique gave external alignment and internal functional repair. Subalar grafting, a technique developed by Dr. Westreich, helped to compensate for his facial asymmetry, even out his nostrils and straighten his tip.