A deviated nose is a common problem among patients for both cosmetic and functional reasons. The correction remains a major challenge for the rhinoplasty surgeon.

Unrecognized nasal septal deviations stand as the primary reason for failed rhinoplasty outcomes.

There is a paucity of data in the literature about septoplasty classifications and technical details in preservation rhinoplasty (PR) for various crooked noses.

The aim of this article is to provide a comprehensive overview of the various septum deviations according to the nasal axis.

Moreover, a treatment algorithm is suggested with technical details based on PR principles.