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Facial Plast Surg
DOI: 10.1055/a-2764-3269
Original Article

Structural Nasal Tip Grafting: Anatomy, Evaluation, and Technique Selection for Durable Aesthetic and Functional Outcomes

Authors

  • Andrew A. Winkler 

    1   Department of Otolaryngology – Head and Neck Surgery, University of Colorado at Anschutz Medical Campus, Aurora, Colorado, United States

  • Nam K. Lee 

    1   Department of Otolaryngology – Head and Neck Surgery, University of Colorado at Anschutz Medical Campus, Aurora, Colorado, United States
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Abstract

Aims and Backgrounds

This study aims to review contemporary principles of structural nasal tip grafting and provide a practical framework for selecting techniques that achieve durable aesthetic and functional outcomes.

Historical Aspects

We summarize the evolution from reduction rhinoplasty toward preservation and structural approaches that prioritize long-term tip support.

Anatomy

Key osteocartilaginous and soft tissue support mechanisms of the nasal tip are outlined with emphasis on major and minor tip support structures.

Technology

Open and endonasal approaches, autologous cartilage sources, and ancillary materials such as fascia are described as tools to modify tip contour and support.

Patient Selection

Clinical assessment focuses on skin–soft tissue envelope, cartilage strength, airway function, and dynamic deformities.

Techniques

Stepwise algorithms for columellar strut and septal extension grafts, plumping grafts, alar rim and batten grafts, lateral crural struts, shield and cap grafts, and articulated alar rim grafts are presented.

Post Operative Care

Postoperative management to protect graft position and control edema is reviewed.

Current and Future Development

Emerging trends toward individualized, data-informed rhinoplasty and objective outcomes assessment are discussed.

Conclusions and Clinical Relevance

Thoughtful selection and execution of structural tip grafts allow surgeons to achieve stable, reproducible tip shape while optimizing nasal airway function.

Keywords

nasal tip - rhinoplasty - structural grafting - septal extension graft - alar rim graft

Ethical Approval

This article is a narrative and technique-focused review and does not involve new studies with human participants or animals. No identifiable patient information or clinical images are included.




Publication History

Received: 14 November 2025

Accepted: 03 December 2025

Accepted Manuscript online:
05 December 2025

Article published online:
15 December 2025

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