Hispanic female patient complaining of nasal obstruction and unhappy with her nasal appearance following a rhinoplasty.

Procedure: Secondary open rhinoplasty, septoplasty, turbinoplasty and platelet gel. Revision osteotomies, right spreader graft, onlay grafts and crushed domal onlay grafts were placed.

Comments: 6 month postoperative photos reveal an improved right middle vault that had a hemi-inverted "V" appearance and the profile has increased definition and projection.