Primary rhinoplasty on a young lady that was self-conscious about her droopy, heavy nose. Without losing her ethnicity you can see how focus and balance has been restored to her eyes and mouth. Even though a patient with thick nasal skin, we were able to refine the contours and turn a heavy tip into an elegant central feature of her nose. Bone contouring was performed using Piezo. Tip reshaping included a Septal extension graft and transposition of cranially misplaced alar cartilages.