14 year old female requests reduction rhinoplasty. Note also when she smiled, the tip dropped even more. Patient shown at 8 days post surgery with open rhinoplasty approach and alar (nostril reduction) as well. Defatting the thick skin with 3D technology as well as multiple cartilage grafting to the tip from the septum was the key to this result. Dramatic improvement can be seen, although patient is still swollen. Teenagers with large noses may be psychologically traumatized by ridicule, but the earliest Dr. Rizk would do a female teenager is 14 years of age.