FINDINGS: Weak alar rims secondary to malpositioned lower lateral cartilage causing collapse, right deviated septum with spur over-projected tip,caudal deviation to right & narrow middle vault (right greater than left) and nasal tip ptosis.

Procedure: Open septorhinoplasty with spreader grafts, columellar strut, caudal septoplasty, turbinoplasty, medial and lateral crural overlay to help deproject the tip.