The rhinoseptoplasty is the total removal of extracorporeal septal cartilage and bone, and the treatment of deviations outside of the bed, and their return as a free graft. It has great relevance in the decision of certain surgical septal deviations as though it may be simple to correct a slight deviation to the classical approaches; the same cannot be said for the severe septal deviations. Recent studies show that this is a more efficient technique for such deviations, with the risk of complications is not superior to conventional techniques and can be performed by less experienced surgeons to them with results comparable to those more experienced. We discuss this technique in the context of the evolution of septoplasty, addressing indications, technique, results, complications and our experience.