Many patients of rhytidectomy age have had previous rhinoplasty or nasal injury and have dorsal irregularities or saddle-nose deformities. SMAS tissue ordinarily discarded at rhytidectomy may be used for nasal dorsal augmentation and padding. Six patients undergoing rhytidectomy who also had prior nasal surgery or deformity were selected. Two of the patients had saddle deformities, and four had palpable and visible bony or cartilaginous irregularities. In all patients, substantial improvement was noted. In the saddle deformities, significant long-term results were achieved, with graft longevity as great as 24 months. The technique should be considered in rhytidectomy patients with concomitant nasal dorsal deformities.