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This lady underwent an open ultrasonic rhinoplasty to feminise the nasal profile and correct an underlying septal deviation. She was particularly concerned about keeping the nose narrow and contoured from the front (whilst making it straighter) – this is always a goal in rhinoplasty although absolute width depends on thickness of the skin (thin here) and nasal bones. Surgery involved removal of a dorsal bump and height reduction using a piezo technique as well as correction of an underlying deviation. Fixing the tip point in the right place was key to creating a feminine side profile with a naturally appearing supratip break. She was absolutely thrilled with the change. Outcome at 2 months.