This patient is a 27 year old female who has undergone 2 previous rhinoplasties  by another physician and is unhappy with the appearance of her nose.  Examination of her pre-operative  frontal photos  demonstrates an overly thin dorsum and severe tip asymmetry with bossa formation.  Her lateral view shows a long nose with a severe hanging columella and slight alar retraction. 

She underwent a revision rhinoplasty with placement of spreader grafts to widen her dorsum and complete reconstruction of her nasal tip with lateral cartilage replacement and correction of her bossa, asymmetry, hanging columella and alar retraction. 

Her post-operative frontal view demonstrates how the dorsum has been widened slightly, the tip bossa have been corrected and the asymmetries corrected.  The lateral view shows the columellar-alar proportion to be corrected by both tucking up the columella and bringing the alar margins down.  The nose has been shortened and slightly rotated.  The overall appearance is a very balanced beautiful nose.