This is a slightly unusual example of revision rhinoplasty in a patient from England who had prior surgery by another plastic surgeon. Despite his Asian background, this particular patient did not desire a strictly ethnic appearing nose. Instead, he desired reshaping to achieve a more projected nasal tip, a higher radix and less of the sharply inverted shadow along the frontal view. Dr. Hilinski used ear grafts and an open revision approach, including a shield shaped tip graft and a fascia-wrapped radix graft. The nasal bones were also narrowed to give a more favorable front shadow. These post-operative progress photos were sent to Dr. Hilinski from England and reflect an overall improvement in his nasal shape.