Primary rhinoplasty of a complicated case. Patient complaining of significant obstruction from breathing on both sides of her nose, nasal tip asymmetries and nostril asymmetry. She was noted to have very thin nasal skin on examination with septal deviation, lower lateral cartilage internal re-curvature, and significant lower lateral cartilage asymmetry. Primary rhinoplasty included bilateral spreader grafts, hump reduction, caudal septal extension graft and lateral crural strut grafts.






















































































































































































































