Conventional septoplasty cannot be the answer to all types of septal deviation. Indications of extracorporal septal reconstruction with polydioxanone (PDS) foil: (i) selected cases of very high septal deviations, (ii) post-traumatic and (iii) extremely pronounced congenital septal deviations and/or aesthetic deformities. Polydioxanone foil facilitates the incorporation of a newly implanted septal graft without significant postoperative complications and is absorbed within 25 weeks. The surgical technique is described in detail, and the early postoperative functional and aesthetic results (mean follow-up: 11 months) on 16 patients (mean age: 42 years) are reported. Overall, 88% of the patients responded positively to the question of whether they would choose to undergo the same procedure again, knowing the postoperative result. The procedure is easy to learn and has already proved to be an excellent combination of modern functional and aesthetic nasal surgery.