Successful management of the persistently crooked nose after a previous trauma or surgery is best achieved through careful analysis of the problem and clear communication with the patient regarding his or her goals of revision surgery. To address the nose in a systematic fashion, the surgeon should divide the crooked nose into horizontal thirds with appropriate management directed toward the structural abnormality in each third. A review of the treatment of the postrhinoplasty and posttraumatic crooked nose is presented with an emphasis on re-establishing structural support and improving appearance while preserving or creating a functional nasal airway.