When performing functional nasal surgery, the surgeon must have the ability to diagnose and correct a variety of septal deformities. Failure to recognize and repair deformities of the dorsal-caudal septum can often lead to persistent nasal obstruction. This session will provide a graduated method to septoplasty/major septal reconstruction, with focus on the external rhinoplasty approach to gain access to and repair even the most severe septal deformities. A progressive array of deformities and their respective methods of treatment will be discussed. Learning Objectives: 1. Apply techniques of major septal reconstruction using an external rhinoplasty approach to improve surgical outcomes. 2. Recognize difficult nasoseptal configurations that may not be adequately corrected by a closed septoplasty technique. 3. Review components of the internal/external nasal valves, and potential contribution to nasal valve insufficiency/obstruction.Faculty: Mark Armeni, MD, FACS(Nothing to Disclose).