Female patient that had underwent a previous rhinoplasty and had sustained a laceration to the left superior nostril near the dome. She had severe nasal obstruction.

Procedure: Secondary Rhinoplasty with placement of bilateral alar batten grafts, lcolumellar strut, left alar rim graft, deep temporalis fascia harvest, Septoplasty, and turbinoplasty.

FINDINGS: Over-resected lower lateral cartilage (left 6 mm and lateral half previously exised, right weak, concave) and weak left alar rim secondary to previous laceration from trauma causing external valve collapse, minimal to no tip support with buckling of medial crura, left deviated septum with spur. Bilateral turbinate hypertrophy.

Comments: After 3 months, her nasal contour has improved and her nasal obstruction also has improved. The left rim graft helped open the constricted left ala where the laceration was and the deep temporalis fascia helped soften the nasal tip. Moderate swelling is still noted on her profile in the region of the supra-tip which will resolve over the next few months.