Nasal dorsum reconstruction is regarded as the most challenging aspect of plastic surgery, depression of nasal dorsum may occur in the bony or cartilaginous portion. Aim of work is to study and implement the different surgical treatment options for management of different grades of saddle nose deformity. The study included 10 patients with various degrees and etiology of nasal dorsum depression through an open approach. Management of saddle nose deformity with cartilage or bony graft for nasal augmentation provides the optimum cosmetic result.