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
