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This 40 year-old lady suffered a significant deformity following a rhinoplasty as a teenager many years ago. Excessive septum was removed in an attempt to fix the underlying deviation such that the tip just fell off the end of the septum without any support. A revision rhinoplasty was performed, which involved a complete reconstruction of the septum and tip to deliver a more feminine and refined profile from front and side. The dorsal height was reduced from the residual septum and tip support and projection achieved through use of a septal bone/ cartilage graft to build up tip support (septal extension graft). She was delighted with the outcome and renewed confidence at 2 months. As an additional benefit, her breathing was much improved following surgery.