A man in his 20s, 6 months post-op revision rhinoplasty. The patient had a previous rhinoplasty which resulted in a foreshortened and over-rotated nose with severe alar retraction and lack of an appropriate tip-defining point with nostril asymmetry. He underwent revision with MTF cartilage using extended spreader grafts to help de-rotate and lengthen the tip, placement of extended alar contour grafts to treat severe alar retraction, and nasal tip refinement. The overall goal is a natural looking result which complements the rest of his face and less nostril show (ability to see inside the nostrils).