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CASE DESCRIPTION: This is a 38-year-old resident of San Francisco who presented to the San Francisco Union Square office in San Francisco, California for evaluation for an external rhinoplasty. Her complaints were difficulty breathing as well as an enlarged dorsal hump and a broad, bulbous tip. She underwent nose reshaping with nasal dorsal reduction and tip refinement and an external nasoseptal reconstruction to improve her breathing. Her surgery was performed at Marin Cosmetic Surgery Center in Marin County, California. Her photographs were taken approximately 1½ years after her surgical procedure.