41-year-old female presenting today in consultation regarding aesthetic nasal concerns. The patient desires dorsal hump reduction, increased tip rotation for a ptotic nasal tip, reduced nasal base, tip refinement. She is a nephrologist and is from El Salvador. She had previous septoplasty through an open approach with a columellar strut graft. She notes some allergies and is using flonase and irrigations. She is early in her postoperative recovery. A Revision joseph rhinoplasty, weir excisions LLH osteotomies, Dorsal sculpting, left SEG, costal cartilage graft, left spreader graft, and crushed cartilage supra-tip graft was performed. She is 3 months postoperative.