A Joseph resection of the dorsal hump permanently alters the nasal dor
sum from a fused smooth cap into three individual components with an o
pen roof. Ln those patients in whom infracture is unwise or in whom th
e septum is severely twisted or the skin is very thin and likely to sh
ow irregularities, reconstruction of the cap is done with a cartilagin
ous dorsal graft that has been sanded thin.