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4 months following a revision rhinoplasty. This patient was unhappy with her functional and aesthetic results following a primary rhinoplasty with another surgeon. A structural rhinoplasty approach was performed to correct an inverted V deformity of the nasal bridge, reposition and strengthen the alar cartilages to allow for an improved airway and correct alar notching, straighten the nasal bridge, fix the twisted nasal tip, reshape the pinched nasal tip, and correct contour irregularities of the nasal bridge.