26 year old with a prominent, downturned nose, a low nasal frontal angle and broad nostrils. This patient asked Dr. Slupchynskyj to raise her bridge and nasal frontal angle, refine the nasal tip, and narrow her nostril width. Rhinoplasty Surgery included reduction of the bony nasal dorsum, and placement of a custom carved silastic implant to enhance her bridge. The nasal tip shape was refined and elevated with Cartilage Strut and Shield Graft placement. Nostril width was diminished with a vertical and horizontal nasal narrowing technique, which helped maintain the natural shape of the nasal nostrils.