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This young patient never had a nasal fracture, though the nose appeared twisted with a saddle in its middle. The tip was somewhat low with a neutral, tip to lip angle, proportion and the columella retracted upward, under the tip. Rhinoplasty was completed with reduction of the hump, using a graft on the bridge to bring up the saddle. The tip was shaped and rotated while the columella was brought into balanced.
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