The septum can present daunting challenges with both aesthetic and functional airway concerns to the rhinoplastic surgeon. The authors have reviewed the areas that are most problematic of the dorsal 'C' or 'S' shaped septal deviation, the caudal septal deviation, and inadequate septal tip support with examples of the techniques used to correct them. As with all aspects of septorhinoplasty, the key to consistent aesthetically pleasing and functional results is appropriate preoperative assessment and planning of the procedure. To be included in this is appropriate counseling of the patient regarding realistic expectations for the procedure, especially with the severely twisted nose.
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