This was a very challenging revision case. The patient had undergone previous rhinoplasty and was left with a malformed, overprojected, dependent, twisted, asymmetrical nasal tip, as well as bony irregularities on the dorsum. We managed to give him a pleasing nasal profile, decreased his columellar show, make the tip substantially smaller and more symmetrical, as well as give him a nicely balanced profile. The intraoperative photos show how asymmetrical the tip cartilages were once they became exposed. This was rectified by placement of a strut (the yellowish straight piece of cartilage between the tips). We were able to make his tip much more, if not perfectly, symmetrical.