The nasal reconstruction becomes extremely important in the rehabilitation of disfigured victims. This study aimed to describe the technique of structural rhinoplasty with autologous costal cartilage for nasal reconstruction in patients with saddle nose deformity and evaluate the aesthetic results, functional and patient. A descriptive study was conducted evaluating 10 patients with saddle nose who underwent structural rhinoplasty with costal cartilage graft. The preoperative symptoms were, more common, aesthetic complaints and nasal obstruction (100%), followed by nasal crusting (80%), epistaxis (70%) and nasal whistling (20%). Columellar retraction and asymmetry of the nasal tip were observed in 80% and 90% of patients. In total, 62.5% and 55.5% of patients showed improvement after surgery, respectively. Structural rhinoplasty with costal cartilage grafts permits a good quantity of cartilage in the manufacture of allowing a safe nasal reconstruction of the saddle nose. The use of diced cartilage wrapped with temporal fascia increased the nasal dorsum in patients with saddle nose and showed a lower risk of twisting and allowed a more natural appearance to the nasal dorsum with satisfactory result. The septal L-strut reconstruction was essential in structuring the nose leading to good functional outcome, improvement of nasal patency.