This is a 63 year old woman who had breathing issues and cosmetic concerns about her nose. She had several accidents and had been living with poor breathing for many years. She underwent a septo-rhinoplasty through an open approach. This included a dorsal reduction, septal straightening, and tip refinement. She did very well after surgery with minimal bruising. At 8 weeks after surgery, she is 8 very happy with the results. Her breathing is much better and the shape of her nose has a more refined appearance.