Pre-Operative Diagnosis: Nasal obstruction secondary to malpositioned lower lateral cartilages (external valve collapse)/Internal valve collapse, turbinate hypertrophy and deviated septum.

Septal Deviation
Bilateral turbinate hypertrophy

Procedure: External Septorhinoplasty with placement of bilateral lateral crural strut grafts, spreader grafts, columellar strut and repositioning of the lower lateral cartilages. Turbinoplasty and platelet gel application.

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

Comment: Her 2 year post op photos reveal an improved nose.