The nasal reconstruction surgery in recent decades is giving otolaryngology valuable tools that allow the reconstruction of vital structures in the nasal function. Now the back and the tip can reconstruct almost all, with the use of autologous auricular and costal cartilage; the floor of the nasal passage and receive two valuable tools: pure titanium microplates and free grafts microvascularized osteomiocutaneos compounds. Because this is a study review of 45 cases of nasal reconstruction that validate these tools.