Several years ago, I devised a method of forming and inserting a bone graft into a nose which would correct lost support of the dorsum and maintain elevation of the tip without resorting to the use of a columella strut. Describing the method to several of my colleagues, they persuaded me to publish the procedure. Before describing the principles and techniques employed, the general subject of the nose and its correction will be briefly reviewed, as it has a direct bearing on the subject. Fortunately, the saddle back nose caused by syphilis is of infrequent occurrence today. That statement is made because it is a difficult deformity to correct, as not only is the skeletal support missing but frequently skin and mucous membrane has been damaged and contracted in the early, destructive process, which necessitates creating a skin covering and a mucous-membrane lining before resorting to a graft.