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

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.We summarize the evolution from reduction rhinoplasty toward preservation and structural approaches that prioritize long-term tip support.Key osteocartilaginous and soft tissue support mechanisms of the nasal tip are outlined with emphasis on major and minor tip support structures.Open and endonasal approaches, autologous cartilage sources, and ancillary materials such as fascia are described as tools to modify tip contour and support.Clinical assessment focuses on skin-soft tissue envelope, cartilage strength, airway function, and dynamic deformities.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.Postoperative management to protect graft position and control edema is reviewed.Emerging trends toward individualized, data-informed rhinoplasty and objective outcomes assessment are discussed.Thoughtful selection and execution of structural tip grafts allow surgeons to achieve stable, reproducible tip shape while optimizing nasal airway function.