This female patient desired reshaping of her nose for both functional and cosmetic reasons. She had a very wide bridge as well as a depressed dorsal contour following prior rhinoplasty surgery by another plastic surgeon. In addition, she had rather obvious asymmetry of her nostrils as seen on front view. Her nasal bones proved to be quite fragile during attempts to narrow her bridge, which limited the amount of change that could ultimately be made to her nose. Despite these unexpected anatomical limitations, Dr. Hilinski was able to achieve an overall improvement using ear and fascia grafting while maintaining a natural looking nose for her face and age.