35 year old patient unhappy with surgical results from a previous Rhinoplasty with another surgeon. Dr. Slupchynskyj proceeded with Revision Rhinoplasty by placing a custom carved silastic implant in the dorsum. Her tip was elongated using cartilage strut and shield grafts which also increased projection and length of the nose to a more balanced look. The tip was refined through defatting of fibrous tissue and removal of scar tissue, which resulted from the other surgeon's work. Insertion of a cartilage shield and strut graft further defined the nasal tip. A vertical nostril narrowing technique was performed; however, was limited by a previous nostril narrowing attempt by the other surgeon. It should be noted that Ethnic Revision Rhinoplasty Surgery is notoriously more difficult to perform since poor results of another surgeon are difficult to correct.