This young woman had rhinoplasty in Toronto. She disliked the appearance of her nose. In particular the rounded nature of the profile and width of the tip. Her case was complicated by the shape of her nostrils. The nostrils were angled upwards, sometimes called alar retraction. When this happens the inside of the nose is too visible from the side. Plastic surgeons refer to this an excess of collumellar show. When one raises the tip these nostrils will become more visible which can be un attractive. Therefore as part of the surgery we lower the rim of the nostrils placing tiny grafts of cartilage called alr rim grafts. During her surgery the lower part of the bridge was reduced to improve the rounded appearance. The hanging collumella ( piece in the middle between the nostrils)was reduced and the tip was narrowed along with the nostril lowering grafts mentioned before. Her results are shown 1 year after surgery. Her nose is now in better balance less rounded and the tip is more refined.