Open structure rhinoplasty with rib grafting

Open approach with rib cartilage harvest and grafting.  39 year old male who had a crush injury to his face 20 years ago.  He had reconstruction surgery at the time of the accident.  He continued to have troubles breathing through his crooked, foreshortened nose.

Open structure rhinoplasty with rib cartilage grafting: septoplasty, spreader grafts, caudal  septal extension graft, lateral crural strut graft with repositioning, batten grafts, and soft tissue onlay.

2 months later, his nose is straighter, longer, and more masculine, matching the rest of his face.  His nasal breathing is also improved.  His 2cm chest scar is barely visible.