Tertiary rhinoplasty for patient with two prior surgeries, about 14 months after most recent procedure with total collapse of the left dome due to multiple injuries to the cartilage, as well as persistent dorsal hump (subtle). I performed a component dorsal reduction, harvested her septum and also repositioned this slightly, placed a columellar strut graft, lateral crural strut graft, and utilized multiple tip sutures to reconstruct and stabilize the reconstructed nasal framework. Most importantly, she is happy now (most recent follow-up was at about 8 months post-op).