25 year old complaining of a low nasal dorsum or bridge, and a wide bulbous tip with wide nostrils. Placement of a custom carved silastic implant, the SLUPimplant™, resulted in augmentation and raising of the nasal dorsal bridge. Refinement of the nasal tip included defatting the nasal tip structures and placing a cartilage strut and shield graft to re-support, rotate and further define the tip. A mild reduction of the nasal alar width was performed using a horizontal narrowing technique. The after photos show results 10 days post-operatively.