Patient is an eighteen-year-old female who was born with Binder’s syndrome, a congenitally very flat nose with poor projection of the whole nose. She underwent a complex rhinoplasty that involved cartilage grafting and complete re-sculpting and shaping of the nasal tip and bridge. Cartilage grafts were placed along the bridge and tip of her nose. Nasal sidewalls were also narrowed. To improve airflow dynamics through her nose, submucous resection of her turbinates was also performed at the time of surgery.