Decortication of the nose is a combination of the extranasal and intranasal approach to the surgery of the nasal pyramid and nasal septum. It consists of temporary removal (decortication) of the skin from the infrastructure of the tip and dorsum of the nose through a columellar and slot incision. This method makes it possible to perform very precisely a wide spectrum of surgical interventions under visual inspection and thus guarantees the basic surgical postulate of good surveillance over the operative field. We have used this method in 500 cases and evaluated the esthetic and functional results of the operation in all of these patients. This modified technique meets all the requirements of functional rhinosurgery.