In this patient, the tip is disharmonious in relation to the dorsum, with excessive convexity of the alar cartilages, which are configured in an upward-facing “parenthesis” shape. This particular anatomical configuration of the tip cartilages makes the central portion of the tip appear somewhat overly “robust,” while the more lateral portion appears almost devoid of cartilage. In the profile view, the osteocartilaginous dorsal hump is evident, as is a certain degree of “heaviness” of the tip. This is a true “refinement rhinoplasty,” in which the margin for error is minimal and the quality of the outcome depends on specific details: the nasal proportions must be improved by elevating the tip, refining its shape with sutures and thin cartilage grafts, and accurately lowering the dorsum without creating a concavity. The patient desires a natural result that enhances the pleasant proportions of her face.