Maxillofacial Surgeon Dr. S. M. Balaji expertly performed the rhinoplasty surgery to correct the profile of the nose using costo chondral graft through intra oral approach. A sulcular incision was placed and through an intraoral approach, the costo chondral graft harvested from the rib was inserted into the nasal septal region and stabilized with the adjacent nasal cartilages. Thus the dorsum of the nose was enhanced with the graft. The nose defect was successfully corrected without any scars and the results were immediate. The boy and his family were very happy with the surgery outcome and the improved facial appearance.