This patient had nasal silicone implant ( I type) on the nasal bridge, and used septal and conchal cartilage for his tip surgery.
However, as time passes, Nasal tip and supra tip area dropped and the nasal bridge deformed.
You can see the short silicone implant on his nasal bridge from the X-ray, and the subsequent step deformity on the preoperative lateral view in the middle.
So, Replaced nasal silicone implant with autologous cartilage, and corrected nasal tip as re-building cartilage support.
It is sometimes difficult to expect how much the tip projection will decrease as time passes, but with proper technique using autologous tissue, the margin of error should be within 10%.