A three-year-old boy was referred to our clinic for a draining lesion on the dorsum of the nose, several months following the surgical excision of a nasal dermoid cyst in Egypt. Physical examination demonstrated a pit on the skin of the nasal dorsum, and magnetic resonance imaging (MRI) was consistent with dermoid cyst recurrence. The patient underwent reoperation using a combined vertical incision and open rhinoplasty approach, with excellent pathologic and cosmetic results. Here, we present this case as a surgical approach to consider in the excision of nasal dermoid cysts.