Several articles have been published about the short nose, many of which begin with a statement about the difficulty and complexity that this deformity poses for the rhinoplasty surgeon. Regardless of the challenges, many surgeons have undertaken the task of elongating the short nose and have subsequently shared with the rhinoplasty community the subtle techniques they have developed through their experience. The authors present a review of the literature that has contributed to the understanding of the etiology, evaluation, assessment, and operative procedures in the reconstruction of the short nose, specifically with regard to septal extension grafts. Additionally, the senior author's (BG) technique and experience of nearly 30 years of practice is described.