A crooked nose, mostly accompanied by a deviated nasal septum, especially a crooked cartilage cone, is basically caused by a deviated septum. The shape of the nasal septum determines the shape of the nasal bridge. For the crooked nose caused by deviated septum, it is necessary to address both the ventilation function and to improve the shape of the external nose. Plastic surgeons and otorhinolaryngology head and neck surgeons have done a lot of work on this and have achieved better results. In cases where the nasal septum cartilage itself is still straight but deviates from the midline and intersects with the posterior septum at an obtuse angle or the anterior lower edge of the nasal septum cartilage is dislocated and causes the cartilaginous segment of the nose to be crooked, the predecessors in the rhinology field corrected the septal deviation, dislocation of the nasal septum cartilage and crooked nose at the same time through the turnstile method of surgery. For those who have a crooked nose caused by the cartilaginous segment of the nasal septum caused by the flatness of the square cartilage itself but the deviation of the connection with the surrounding bones and cartilage and the deformity of the tip of the nose caused by the dislocation of the anterior lower edge of the square cartilage to one side of the nasal cavity, the author further separates the connection of the square cartilage with the cartilage of the nasal dorsum and the nasal columella on the basis of the nasal endoscopic three-line reduction method to correct the nasal septum, and fractures and strips the bones and cartilage of the connection as needed to make the square cartilage At present, for deviated septum combined with crooked nose, the most common method at home and abroad is to remove the deviated square cartilage, trim it into an L-shaped brace, or remove the vertical plate of plow bone sieve bone, spread it, reinsert it, and fix it between the cartilages of nasal dorsum to correct the nasal bridge. There are two types of this procedure: external nasal approach and internal nasal approach. In recent years, some authors have also performed simultaneous rhinoplasty on the basis of endoscopic nasal septum correction. In clinical practice we found that a considerable proportion of crooked noses combined with deviated septum of the square cartilage itself is basically flat, the author divided into four types according to the specific situation, and all of them achieve the purpose of septoplasty simultaneous rhinoplasty according to the four-line reduction and repositioning method. The septal deviation consists of the deviation of nasal septal cartilage and bone, most of the septal deviation does not combine the cartilage segment of the crooked nose, only when the anterior segment of the square cartilage to one side of the nasal cavity dislocation or square cartilage is up and down or front and back deviation, making the dorsal edge of the nose out of the midline will cause the cartilage segment of the crooked nose and nasal tip deformity. For the septal deviation combined with cartilage cone distortion, there is a fourth tension zone, which is the connection between the septal cartilage and the nasal dorsal cartilage, the greater wing cartilage and the nasal bone. In this paper, on the basis of the three-line reduction, the tension zone on the upper edge of the square cartilage is also released, i.e. the four-line reduction method. For the square cartilage with curved projection or curved deformity in addition to the deflection of the surrounding junction, the square cartilage can be straightened by making cross resection at the projection or strip resection at the curvature, etc. according to the situation. This surgery only removes the excess cartilage strips and bones that affect the septum and nasal cone remodeling without reducing the height of the septum, ensuring the integrity of the bone and cartilage scaffold that supports the nasal shape, and no surgical complications such as stepped nasal bridge or saddle nose will occur if there is no cartilage necrosis caused by infection. No complications occurred in this group of cases. The correction of the third type in this article, i.e., posterior deviation of the square cartilage, is similar to the traditional surgery of the turnstile method, but this procedure is performed under the nasal endoscope. The indications for this procedure are crooked noses of the conical segment of the external nasal cartilage caused by a basically flat nasal septum but deviating from the midline, so the classification according to the condition of the deviated septum helps to develop the appropriate surgical plan.