The term “hook nose” may refer to a bump along the bridge of the nose, also known as a dorsal hump. The dorsal hump may be bony as well as cartilaginous in nature. I remove a dorsal hump by shaving down the bony and cartilaginous portions of the hump. This can be performed through either an external/open rhinoplasty or a closed/endonasal rhinoplasty. While shaving down the bump of the nose, a rhinoplasty surgeon should be aware of the function of the nose and the fact that shaving a big dorsal hump may compromise the function of the nose and cause nasal airway obstruction. Therefore, at the time of taking down a bum (particularly if that bump is mainly cartilaginous in nature), I reinforce the nasal airway function by placing cartilage grafts in the mid portion of the nose. These grafts are called spreader grafts and they maintain, preserve and improve the nasal function in the region known as the internal nasal valve. Finally, a hook may be due not only to a bump or a dorsal hump but also weakness of the nasal tip. When the nasal tip is weak it may be under projected and/or under rotated. Therefore, when treating a nose that appears like a hook, I emphasize treatment of the nasal tip to at least maintain if not improve its tip support mechanisms as well as alter the projection and rotation as needed to achieve a result that is natural in appearance and compliments the facial harmony of the patient on profile.