Case Study #2. A 35-year-old woman complained of a deviated nose. She had no previous nasal trauma or surgery. A cone-beam CT scan revealed a significant S-shaped septal deviation with a cephalic convexity toward the right and a caudal convexity toward the left. After extensive discussion, the patient did not want any significant changes in her profile or tip. She only wanted a straighter nose and improved respiration. An endonasal approach was done, followed by an extensive septoplasty. Asymmetric osteotomies were done with a low to low osteotomy on the left side (long side) and complete percutaneous osteotomies on the right side. Finally, an asymmetric push down technique was done by rotating the nasal pyramid en bloc onto the left side. The patient is shown preoperatively (A, D, G), 8 days postoperatively (B, E), and 1 year postoperatively (C, F, H).