45 year old patient complained of a wide or broad lower nasal third and low flat dorsum. He requested an elevation of the bridge and naso-frontal angle with narrowing of the nostrils with refining of the tip. Open Rhinoplasty Surgery was performed with placement of the custom carved SLUPimplant™ to raise the dorsum and also further refine the bridge. In addition, bilateral osteotomies reduced the width of bridge. Nasal Refining Surgery included defatting of the nasal tissue and placement of cartilage strut and shield grafts to enhance and define the tip. This patient also requested a narrowing of the nostrils, which was performed using a vertical and horizontal nasal narrowing technique.