The septal L-strut extension graft (SLEG) is a versatile technique used in both primary and secondary septorhinoplasty. In primary cases, SLEG supports tip and cartilaginous dorsum formation without augmenting the bony dorsum, particularly benefiting pseudohump or mild saddle nose cases. In secondary procedures, SLEG is essential for framework reconstruction. Long-term outcomes show stable dorsum shape, while functionally, SLEG improves nasal airway and suits Asian autogenous-only techniques.