This 27 year old female disliked her moderate dorsal hump and severe drooping nasal tip. The angle between her upper lip abd the base of her nose (columella) was very tight. She was treated with an open rhinoplasty, dorsal hump reduction and tip support using a caudal septal extension graft made from her own septal cartilage. From every angle, she is delighted with her post operative result, photographed several months after her surgery with the rhinoplasty surgeons at Sound Plastic Surgery in Seattle.