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Open approach with rib cartilage harvest and grafting.
22 year old female who was unhappy with the shape of her nose. It was deviated to the left, dorsal hump, retracted nostrils, excessive columellar show.
Septoplasty and Open structure rhinoplasty with rib cartilage grafting: spreader grafts, caudal septal extension graft, lateral crural strut grafts with repositioning, and soft tissue onlay.
3 months later she has improvement of her profile, while maintaining her ethnicity. The nose is straighter and her nostrils are no longer arched. Nasal breathing is preserved.