A woman in her 40s, who had two previous rhinoplasties which left her with an elongated nose, an overprojecting nasal tip, tip asymmetry, a significant septal perforation, and inability to breathe through her nose. She is now one week post-op from tertiary revision rhinoplasty with correction of tip asymmetry, tip deprojection to shorten her nose, and placement of a columellar strut graft, spreader grafts, and alar contour grafts using MTF cartilage. She has significant improvement in breathing. Disclaimer: most patients have much more swelling and bruising at one week post-op. It generally takes 1.5 years for swelling to completely resolve.