External nasal deviation is caused primarily by severely a deformed septum. The nose functions as a whole composed of the septum, valve systems, and mucosal structures. Patients with severely deviated septums also have deformed nasal valve systems. Extracorporeal septoplasty is advocated for an extremely deviated nasal septum. Nasal valve dysfunctions can be resolved successfully with spreader grafts. Application of extracorporeal septoplasty in combination with spreader grafts in patients with nasal valve dysfunction not only enables nasal respiration but also supports aesthetic appearance. The 19 patients in our study had undergone aesthetic rhinoplasty and presented with breathing problems and septal deviations. The patients were treated with extracorporeal septoplasty and spreader grafts. The patients were followed with clinical measures and computed tomographic scanning. No complications such as relapse, perforation, or saddling were encountered during follow-up. Aesthetically and functionally satisfactory results were obtained.