55 year old woman who had undergone rhinoplasty approximately 20 years prior to presenting for a revision. She had a severely pinched and narrow nasal tip with significant nostril rim (alar) retraction. Due to the severity of the deformity and degree of scarring present, she required extensive cartilage and fascia grafting. After undergoing revision rhinoplasty performed by Dr. Amit Bhrany, she persists to have some asymmetry, but has a more symmetric and natural appearing nose with significant improvement in her nasal breathing.