39 year old patient complaining of a flat, nasal bridge, wide nostrils and undefined nasal tip. An Open Rhinoplasty technique was performed, as well as refining nasal tip surgery. Dr Slupchynskyj placed a custom carved silastic implant, the SLUPimplant™ to augment, refine and enhance the bridge. He also had a reduction of nasal alar width using a vertical and horizontal nostril narrowing technique. Cartilage strut and shield grafts were placed to define and support the tip. There is still swelling shown in the dorsum and tip areas as the photo was taken a few days post operatively. Patient is very happy with results.