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

Aims and Backgrounds: 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 allows surgeons to achieve stable, reproducible tip shape while optimizing nasal airway function.