A woman in her 20s, two months post-op revision rhinoplasty. This patient had three previous rhinoplasties which left her with a severely deviated septum with inability to breathe, drooping nasal tip, over projecting nasal tip, alar retraction, and a dorsal hump. She underwent revision rhinoplasty with septal reset with spreader grafts to straighten her nose and improve breathing, nasal tip deprojection to shorten her elongated nose, dorsal hump reduction, nasal tip refinement, alar contour grafts to help treat alar retraction, columellar strut graft for tip support, and tip elevation. MTF cartilage was used for all cartilage grafts. The overall goal is a natural looking result which complements the rest of her face.