25 year old African-American female who underwent two previous nose surgeries with another Pastic Surgeon in New York in order to refine both her dorsum and bulbous nasal tip. This surgeon improperly placed a preformed silicone implant upside down in her primary rhinoplasty causing extrusion. During the second Rhinoplasty, the preformed silicone implant was placed in the wrong tissue plane without suturing. This caused it to migrate. The patient suffered unnecessary complications twice and saw no satisfactory refinement of her dorsal width or of her nasal tip. She is shown here before and after Ethnic Revision Rhinoplasty using an Open Rhinoplasty technique, the custom carved implant (SLUPimplant™).