Notes from Dr. Siegel: This African American woman was mostly bothered by the appearance of her nose from the front: Her wide nasal bones, her bulbous tip, and the overall width of the nasal tip. She wanted a subtle refinement from her side view – mainly a hump reduction and mild tip elevation. Her overall goal was changes that would maintain her ethnic identity. We performed an ultrasonic rhinoplasty to narrow her nasal bones and provide a narrower nasal appearance on the front view. Her tip was reshaped to achieve a less-round, more defined appearance. Her nostrils were slightly narrowed via an alar base reduction with “invisible” incisions.