This 30 year old girl had a nose job performed by another surgeon twice before. She was still unhappy with the hump of her nose and the shape of her nose tip. Dr. Jaime Perez performed open rhinoplasty with cartilage grafts to correct the shape of her nasal tip and the dorsal hump. Dr. Perez is experienced in secondary and tertiary rhinoplasty surgery. He routinely operates on patients who still have problems after previous rhinoplasty's. In that case cartilage gratfs are harvest from other areas in the body other than the nose such as the ribs or ears.