For this complex secondary rhinoplasty, the compromised nasal framework was reconstructed using an autologous costa greft to rebuild a secure foundation. During the detailed structural correction, the septum was reinforced, spreader grafts were placed, and the lateral crura were reinforced with additional grafts to secure the nasal walls. Base symmetry was restored using right and left rim grafts, the bridge was meticulously shaped by suturing a dorsal graft, and a crushed supratip graft was placed to ensure a smooth contour transition, achieving a remarkably stable and balanced result visible at just one week post op.