26 year old with a protuberant, down turned nose and a low nasal frontal angle and wide nostrils. Patient requested Dr. Slupchynskyj to elevate her bridge and nasal frontal angle, refine the nasal tip and narrow her nostril width. Rhinoplasty Surgery included reduction of the bony nasal dorsum, and placement of a custom carved silastic implant to augment her bridge. The nasal tip shape was refined and lifted with placement of cartilage strut and shield grafts. Nostril width was reduced with a vertical and horizontal nasal narrowing technique, which served to maintain the natural curvature of the nasal nostrils.