14 months out after a Rhinoplasty, the overall goal is to always maintain a natural result... The standard key maneuvers included a component hump reduction, reverse angulated caudal septal trim, and tip deprojection. Multiple grafts were used including a columellar strut graft, spreader grafts, alar contour grafts, and a mastoid fascia tip graft. This patient also had a left sided crural strut graft to improve symmetry, and mastoid fascia soft triangle grafts to improve the fulness in those areas (directly underneath the domes of the tip). Please look at the "worm's eye" view (taken from below the patient). I always try to create a surgical scar that is almost invisible. The OR photos are in the last pic and you can see how similar they are to the long term results...