A woman in her 30s, who had a previous rhinoplasty which left her with a bulbous and drooping nasal tip. Her previous surgeon had placed a L-strut silicone implant which resulted in a bulky appearance of her nasal tip. She is now three months post-op from revision rhinoplasty with removal of silicone implant, tip refinement, tip elevation, and placement of a columellar strut graft, spreader grafts, and alar contour grafts using MTF cartilage to add tip support.