A complex problem in asthetic and reconstructive rhinoplasty is correcting the externally deviated nose. Despite the many techniques devised for that purpose, the recurrence rate of nasal deviaton following surgery is still high. This article describes a new method of one block osteotomy using the low lateral osteotomies combined with a transverse osteotomy to secure a more natural configuration and increased stability of the nasal pyramid in deviated noses. We present our experience with 9 consecutive rhinoplasties performed with one block osteotomy with 4 to 24 months follow-up. One block osteotomy has yielded excellent aesthetic results with generally less severe ecchymosis and edema due to simple operative procedures and less nasal mucosal dissection. One block osteotomy combining the low lateral osteotomy routinely with a transverse osteotomy creates a large surface of the mobilized, bony, lateral nasal wall and, therefore, a better support and stability for the nasal pyramid. The patients who performed one block osteotomy were able to return to early social activity. The recurrence of nasal deviation was not noted. The authors suggest that one block osteotomy is an alternative method to correct a deviated nose.