The authors present a series of 20 patients who have undergone a complex septorhinoplasty. Its complexity is due to the presence of a serious deviation of the nasal septum, with an altered anatomy and position, and to the contemporaneous malformation of the nasal profile, laterally displaced in respect to the facial axis and with accentuated hump of the nasal bones. The aim of this presentation is to indicate the resolution of both problems with a single surgical operation.