A woman in her 30s, who had three previous rhinoplasties which left her with a thick and bulbous nasal tip, a dorsal hump, a drooping tip, and inability to breathe through her nose. She is now two months post-op from revision rhinoplasty with 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.