I'm Dr. William Portuese from Seattle. Today we're going to talk about revision rhinoplasty. A revision rhinoplasty involves another procedure performed on the nose, for patients who've had a previous rhinoplasty in the past. They're much more difficult and much more complicated because of the fact that there's been previous changes to the normal anatomy, and scar tissue formation in the nose from the previous procedure. A good candidate for a revision rhinoplasty is someone who has realistic expectations about what we can accomplish. There are things we can accomplish, there are things we cannot accomplish. For example, if there's a small indentation in the upper lateral cartilages, and there's plenty of cartilage left on the inside of the nose, we can harvest a small piece of cartilage and put a little spreader graft in that area to build that little dent or that depression up. Another good example would be somebody who maybe has a residual bump on the bridge of their nose, and we can file that down, or somebody who has, their nose is too scooped out, too much cartilage has been taken away, we can come back in and add an additional cartilage graft in that area, usually taken from the inside of the nose. But if there's been a cartilage-depleted nose from prior surgery, then we may have to use a piece of ear cartilage to reconstruct the nose. I would not recommend revision rhinoplasty in someone who has unrealistic expectations. There is no perfect nose. If you want a perfect nose, there's no reason to undergo this type of procedure. There's improvements, but nope, there is not a perfect nose.