This is a young patient who desired a rhinoplasty because she had difficulty breathing and felt her nose was slightly crooked due to her facial asymmetry. She underwent an open rhinoplasty that involved straightening her dorsal aesthetic lines and applying spreader grafts to straighten her nose and improve her breathing. Her septal deviation was also corrected. Due to her facial asymmetry and delicate cartilage, this was a very challenging case but the patient obtained an amazing result.