A woman in her 20s, who had a previous rhinoplasty which left her with a thick and bulbous nasal tip, alar retraction, nostril asymmetry, a dorsal hump, drooping tip, and inability to breathe through her nose. She is now six months post-op from revision rhinoplasty with correction of nasal tip asymmetry, placement of alar contour grafts to correct alar retraction, dorsal hump reduction, tip elevation, and placement of a columellar strut graft and spreader grafts using MTF cartilage to add tip support, tip refinement, and improve her breathing.