Background: Concomitant orthognathic and nasal surgery is becoming the mainstream in orthofacial surgery. The type of intubation is one of the main challenges of the concurrent OS and rhinoplasty. In this case report, we present the history of a patient who underwent the concomitant surgical procedures with the sole nasotracheal intubation. Case Presentation: The patient was affected by class III malocclusion, severe maxillary hypoplasia and a crooked nose. The dorsal nasal preservation rhinoplasty was performed, thus the nasotracheal intubation could be kept for both the maxillary and nasal surgeries. Conclusions: The procedure allowed to restore the facial harmony and function in a single stage surgery, improving patient satisfaction and compliance, and most importantly, reducing the risks related to other types of intubation actually in use.