This 36 year old woman is shown one year following open revision rhinoplasty. She was unhappy with her initial closed rhinoplasty surgery, performed by another plastic surgeon, as it left her with a lumpy, asymmetric tip and excessive nostril show, particularly on the left. She had significant difficulty breathing and congestion as well. Finally, she also desired a slightly straighter and higher bridge. Cartilage grafts from her septum were used to completely reconstruct the nasal tip and add a small amount of height to the bridge. She is extremely happy with her final aesthetic and functional result.