This patient underwent a cosmetic rhinoplasty because she wanted to reduce the width and have more of a slope. Her natural postoperative results were achieved with osteotomies of the nasal bones and a right sided spreader graft. This resulted in narrowing and straightening of the bridge. The tip of the nose was refined with permanent sutures and additional support was achieved with a caudal extension graft. The nostril base was narrowed with an alar base reduction.