Primary rhinoplasty on an elegant young lady, who was seeking for an improvement of her deviated nose. The set targets for this procedure included a medialisation of the nose in front view, tip refinement and deprojection of her bridge, resulting in a feminine profile. Her procedure included Piezo-assisted release and repositioning of her nasal pyramid, unilateral Spreader graft placement, a Septal extension graft and significant alterations to the contours of her alar cartilages. The results are 9 months post OP and as the swelling will continue to settle her nose will appear more and more refined.