Procedure: Secondary septorhinoplasty, turbinoplasty, ear cartilage and fascia grafts, and platelet gel. Grafts used included: spreader grafts, columellar strut, alar batten grafts, alar rim grafts, and crushed cartilage dorsal augmentation.

FINDINGS: Posterior left septal spur, Absent lateral crura bilaterally (intermediate, dome and medial crural present) - see attached intraoperative photos), narrow right greater than left middle vault, poor tip support, collapsed right greater than left external valve collapse, radix and cephalad dorsum over-resected, 3+ skin scarred/adhesed to nasal tip.

Comment: Her post op photos reveal an improvement of her nose. The intraoperative photos reveal the over-resected alar cartilages