This lovely woman in her 60’s had undergone a prior rhinoplasty which was complicated by a severe infection that resulted in signifcant soft tissue and skin damage. She was treated with preoperative nanofat, autologous rib graft reconstructive rhinoplasty, unilateral alar base resection, and multiple scar revisions. She is shown 1 year out from secondary rhinoplasty. There is still evidence of the prior infection, particularly as the swelling goes down over time, but there is nonetheless a good improvement and successful reconstruction of a more natural appearing nose.