This is a 19 year old young healthy girl who in 2012 underwent a septoplasty and resection of her frontal mucus seal in her home city. Since she was younger she has been bothered by the appearance of her nose. It is slightly larger than ideal, with a small dorsal deformity and slight bulbous tip. She still had some residual bowing of the septum from her previous septoplasty. In order to improve her appearance she would require an open rhinoplasty with a takedown of the dorsum, infracting and tipplasty with slight shortening and angulation of the caudal septum. Having discussed all of the risks and benefits she decided to proceed and underwent an unremarkable septorhinoplasty. At three months she is healing nicely. The nose is in good position and is now more feminine and smaller. The tip is less bulbous and will continue to soften over the coming months. She and her mom are quite pleased with her surgical outcome.