This patient has rhinoplasty done in the past and her surgeon left silicon implant inside of her nose .patient was complaining about having foreign body inside and too much moving around.in addition she wasn’t happy with the shape too.there are always the risk of protrusion and infection .so I removed that implant .after removal of that silicon there was a huge space because of cartilage overesection and I reconstructed dorsum and tip with ear cartilage and fascia.in this technique we harvest the fascia from temple and sewing it like a pillow then we fill it up with little tiny diced cartilage and putting it on the dorsum to achieve better height on bridge.tip area has been reconstructed by septal cartilage which was very difficult to get ideal shape.because of those grafting there will be huge swelling and it takes a year in order to see the final result