Summary. Rhinoplasty is often thought of as the most challenging of all aesthetic procedures. Irregularities of nasal tip impli- cate decreasing of nasal function and are generally regarded as an unattractive facial feature. The combined operative techniques which required extracorporeal septoplasty, incorporation of cartilage disc graft and onlay graft were performed in nineteen patients. Among the nineteen patients, fifteen had procedure of primary rhinoplasty and in four of them secondary or revised rhinoplasty was made. Indications for this operative technique were in patients with boxy nasal tip, bifid nasal tip, lateral alar tethering with extremely fat or thin nose skin. We emphasize that this technique is very successful with an acceptable percentage of postoperative complications. The tecnique is method of choice for reconstruction of extreme nasal tip irregularities where the usual reconstruction technique does not give satisfactory results.