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The ability of a surgeon to create an aesthetically pleasing and functionally competent nasal dorsum weighs heavily on following the foundations of rhinoplasty, beginning with the examination and analysis. These same fundamental principles should be used and applied in secondary rhinoplasty. The most common chief complaints of those patients seeking primary rhinoplasty relates to the presence of a hump or dorsal convexity, and similarly complications surrounding the dorsum are the most common indications for secondary rhinoplasty. The surgeon must be able to appropriately evaluate and correct deformities in patients who have already undergone rhinoplasty with dorsal profileplasty. Patients can present with a wide range of postoperative deformities within the bony pyramid or middle vault, including, but not limited to, contour irregularities and internal nasal valve compromise, respectively. The authors will …