This is a 26 year old healthy white female. She is 5’7” and 120lbs. She was initially seen 5 years ago by an ENT for sinus headaches and was noted to have a deviated septum at the time. Unfortunately her symptoms had not improved over the years. She is a mouth breather which is worse at night. Examination showed a dorsal deformity, a wide proximal and mid third, a very bulbous tip with longitudely placed lower lateral cartilages. The internal exam did confirm the deviated septum as well as enlarged turbinates. In order to correct her problem she underwent an open septorhinoplasty with submucus resection. The dorsal deformity was taken down. She underwent the submucus resection, an infracture, repositioning of the lower lateral cartilages and the caudal septum was shortened and angulated. Her postop course was unremarkable. Examination at 2 months shows that the nose is markedly improved from both a cosmetic and functional standpoint. The dorsum is straight, the proximal portion is narrower and the lower lateral cartilage is better positioned. Her breathing is markedly improved. She is quite pleased with her results knowing that it will continue to improve over time.