This 22 year-old gentleman was born with a congenital deformity known as a cleft lip. This deformity creates an open space that extends from the exterior of the lip to the upper jaw bone. Patients who are born with a cleft lip often lack stability of the bones of the upper jaw, which causes the nose to collapse on one side. Although the lip deformity was repaired at birth, he was very unhappy with the indentation of the lip scar. In addition, his nose appeared collapsed and he had intense difficulty breathing through his nose. A rhinoplasty utilizing cartilage from his rib cage was performed in order to reinforce and straighten the nose. Bone graft from his ribs was utilized to build bone support to the upper jaw. In addition, a revision of the lip skin and muscles was performed to create a more aesthetic contour. The result, pictured at 1 year, shows improved symmetry of the nose and a masculine profile.