This is the ideal source of material for grafting on the face. Most surgeons with backgrounds in Otolaryngology prefer this graft due to experience in performing septoplasty. The challenge in harvesting this graft is that the septum is covered by mucoperichondrium on both the left and right sides. The mucoperichondrium is highly fragile and delicate technique is required to prevent perforation. In some cases, the nose has poor physiology which must be improved to allow the lining of the nose (mucoperichondrium) to improve and become stronger. Surgeons harvesting septal cartilage do so by either an open rhinoplasty approach, kilian incision or hemitransfixion incision. An open rhinoplasty approach allows the surgeon to widely separate the cartilage from the septum and can be useful in certain in rhinoplasty operations and types of septal deviation. A kilian incision is an incision on the inside of the nose which is on the septum and useful for deviation in the back of the nose. A hemitransfixion incision is where the incision is made closer to the caudal margin or anterior portion of the nose and allows better access to the anterior portion of the nose and can be used in both open and closed rhinoplasty.