This young Toronto woman had a difficult nose. The main issues were with the tip of the nose. It was quite ptotic (droopy) so the goal was to lift the tip and reduce the hanging collumella seen in the frontal view ( the piece in between the nostrils). The concern was that her nostrils were quite retracted and angled upwards so over exposure of the nostrils was a concern when the tip was lifted. To avoid this problem grafts of cartilage were placed along the rims of the nostrils to push them downwards. These are called alar rim grafts. In addition the hump on the bridge was reduced and the tip was lifted. This was done with an external approach rhinoplasty. Results are shown 3 months following surgery so some swelling still is present in the tip and mid third of the nose. Again the overall effect is to draw attention away from the nose and to the eyes. Lifting the tip also sometimes appears to make a person look younger.