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Mrs. N. had a deviated septum and was unhappy with her profile appearance and nasal asymmetry. A closed Septoplasty and Rhinoplasty was performed. Asymmetry was addressed with a right spreader graft, left tip cartilage removal, and a small right cartilage batten graft to the tip. The nose was slightly de-rotated by trimming the septum and the anterior nasal spine. The result is markedly improved breathing and external nasal symmetry as well as a nicely balanced profile. Results are shown at 1 year after surgery.