Background <p>The septal extension graft, described by Byrd and popularized by Toriumi, was basically designed to prolong the caudal septum and correct the columellar retraction with a termino-terminal location. Numerous septal graft designs have been performed over time with very good results. Herein we present a brand-new variant of septal graft named the S sword septal extension graft(SS-SEG).</p> Methods <p>Between 2020 and 2024, all rhinoplasties carried out by the first author, where this new design was used, were retrospectively reviewed and included in this study. Opportunity (primary or secondary), amount of cartilage in cm2, and surgical time were also reviewed.</p> Results <p>The SS-SEG was used in 769 cases and termino-terminal on pedestal in 11 cases, while septocaudal replacement was used in 4 cases and tongue and groove technique in the remaining case. There were 411 patients who underwent primary rhinoplasty, while 358 patients had been previously operated on. Reduction in surgical time was on average 11&#xa0;min (range 8–15&#xa0;min). Cartilage saving was on average 27% (range 25–29%) if compared with the conventional septal graft. All patients were followed for over one year showing consistent results. Thirty-two reinterventions (4,2%) were performed on the nasal tip during this period of time. All of them were not due to loss of support but rather due to lack of definition in thick skin.</p> Conclusions <p>The variant of septal extension graft, herein presented, saves cartilage, is thinner, therefore offers greater flexibility and naturalness. It also gives definition and support to the tip, as well as to the supratip and infratip, since it is part of this structure as well as aligning and reinforcing the caudal septum.</p> Level of evidence <p>Level III, therapeutic study.</p>