PREOPERATIVE DIAGNOSIS: Gross nasal deformity; s/p rhinoplasty X 2

Procedure: Left conchal cartilage harvest for grafting, Tertiary Revision rhinoplasty, platelet gel application.

FINDINGS: Convex, wide nasal bones, intact middle vault with no subluxation of upper lateral cartilages, no lateral crura identified (intermediate and medial crura present, right slightly larger intermediate crura) bilateral, tip encased with scar and cartilaginous tip graft, depression at left caudal edge of upper lateral crura (return) Grafts placed: bilateral alar batten grafts and columellar strut. 2 mm alar reduction (weir’s) including vestibular tissue.