The deviations of the nasal septum are often encountered at the junction of the quadrangular cartilage, ethmoid, vomer, and maxillary crest. The deviations of the ethmoid lamina should be handled with great care because of its neighborhood with the skull base. It is also easy to make precise cuts using bone-cutting scissors because it is a thin bone. It is possible to harvest a bigger bony-cartilaginous graft by keeping the connection between the septal cartilage and ethmoid. The vomer is a thicker, bilaminar bone. It is possible to resect the deviated parts of the vomer and shave the deviated part to obtain a thin bony graft. The maxillary crest is often affected by septal deviations, and the obstructing portions should be resected. The anterior nasal spine should always be assessed before and during the surgery. The anterior nasal spine can be partially resected if it is off the midline.