Extracorporeal sculpturing of the septum during septorhinoplasty (SRP) is a well-established technique. However, the extent of manipulations of the septum varies amongst authors. In a series of 630 patients undergoing SRP, the authors used a complex extracorporeal septal three dimensional structural composite graft in 63 patients. This technique allows a more precise fashioning of the graft and insertion under vision with proper positioning. The authors used 11 criteria to evaluate their results with a (rather short) mean follow-up period of 19 weeks. They had an 85% improvement in the dorsal axis, an 82% improvement in the tip projection and nasolabial angle. However they noted a 71% reduced stability and broadening in 28% of cases.