Maxillofacial Surgeon Dr. S.M. Balaji skillfully performed the cleft rhinoplasty. The left ala of the nose was severely depressed. Costo-chondral cartilage was harvested and shaped to reconstruct the nasal framework. Through an intranasal approach the depressed left ala was lifted up by placing the shaped graft. The cartilaginous strut graft was positioned between the medial crura to reconstruct the base of the nose. Immediately after the surgery the shape and appearance of the nose improved greatly. Also since the surgery was done from inside the nose, there were no scars. The girl was very happy with her improved appearance & facial profile.