19 yo male with history of nasal trauma and aesthetic concerns of nose.  Patient was very concerned with the dorsal deflection, the dorsal hump, the lack of definition of his tip, and the width of his tip.  Spreader grafts were place along with lateral osteotomies in order to straighten the dorsum, lateral crural flaps were performed to retro displace a prominent nose and a columella strut was used to support his tip.  Cephalic strips with interdomal and transdomal sutures were used to define the tip.  Alar wedge excisions and nostril sill excisions were used to narrow his alae.

Significant nasal reconstruction was necessary to achieve the desired aesthetic result and photos at three months, although showing significant improvement, are not as impressive as the 1 year appearance of this patient's nose because of the prolonged edema.  This case truly demonstrates that the nose will continue to change up to one year following surgery