42 year old male unhappy with the appearance of his nose, especially his left nasal tip. He has had two rhinoplasties in the past and also had trauma to the left tip region.Patient also has bilateral nasal obstruction.

Procedure: Tertiary Revision Rhinoplasty with right ear cartilage graft, septoplasty and composite graft from left ear to right ala. Bilateral alar rim/batten grafts, double-layered infralobular tip grafts, left concha cymba composite graft to lower retracted right ala, columellar strut, septoplasty, conchal cartilage to right peri-alar region, osteotomies, scar tissue from nose placed over nasal tip and right middle vault, right nasal floor composite graft and outfracturing of turbinates were performed.

Note: The right entire alar region is improved and the airway is more patent (base view). The tip has been lengthened and the postoperative photos are similar to the computer morphing photos. A one week postoperative photo of the healing left concha cymba composite graft site (full thickness skin graft in place) is shown.