A 25 year-old lady troubled by a dorsal bump and droopy tip underwent open ultrasonic rhinoplasty to deliver a natural and feminine side profile and improve self-confidence. An ultrasonic technique was selected to achieve accurate bone reshaping with minimal tissue trauma and bruising. A smooth front-on contour was created using auto-spreader grafts. A feminine tip shape with a slight supra-tip break was achieved through a combination of septal extension grafts and a crushed shield graft. Result at 6 months.