Notes from Dr. Siegel: Hispanic patient with thick skin bothered by a very round nasal tip, lack of overall nose definition, and a hump. She desired a more-feminine nose with more definition and a slender profile. An ultrasonic rhinoplasty was used to reshape the bones and transform the hump into a natural profile, and to narrow the overall width of the bridge. The lack of tip definition was treated with a structural rhinoplasty approach.