A woman in her late 40’s who is troubled by her nose “drooping” and a dorsal hump. She also has difficulty breathing, and needs to wear Breath Rite strips to breath better. Her exam shows that she does have collapse at her internal nasal valve, “vestibular stenosis” She is shown before and again, 9 months after open septorhinoplasty with non destructive tip rhinoplasty and bilateral spreader graft placement. There is typically still some swelling in the nasal tip that will continue to improve for 3 years after surgery. She is thrilled with her new nose, and is able to breath in normally through her nose without obstruction, and with out needing to wear an external support.