This patient had suffered a nasal fracture that resulted in a severely deviated septum and an extremely large dorsal hump. He wanted to breathe better and wanted the hump removed. We achieved these through an open approach. With smaller dorsal humps, we can usually remove them through incisions placed only inside the nose. However, with larger humps you risk collapse of the nose and nasal obstruction without combining the hump removal with reconstructive techniques which can require an open approach. His postoperative photos were taken about eighteen months following his surgery. We achieved a nice improvement in his breathing and his nasal appearance while successfully preventing nasal collapse with our reconstructive procedure.