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Mrs. Z. had substantial nasal deviation, breathing obstruction, and was concerned for her profile height and droopy tip. A septoplasty with right and left spreader grafts, as well as turbinate reduction opened up her airways. Bone straightening, profile reduction, and a right subalar graft were also performed as part of the Rhinoplasty in order to straighten her nose and produce a pleasing profile, eliminating the concern for a droopy tip. A columellar strut was placed in order to prevent loss of tip height and maintenance of projection. Results are shown at 1 year.